鼻塞式持续气道正压通气联合气管插管吸痰治疗小婴儿重症肺炎合并Ⅱ型呼吸衰竭

NCPAP joint tracheal intubation sucking phlegm healing small baby with severe pneumonia Ⅱ merger of respiratory failure

目的:探讨鼻塞式持续气道正压通气(nCPAP)联合气管插管吸痰对小婴儿重症肺炎合并Ⅱ型呼吸衰竭的治疗效果与安全性。方法:选择小婴儿重症肺炎合并Ⅱ型呼吸衰竭患儿80例随机分为nCPAP+气管插管吸痰组(A组)和气管插管机械通气组(B组)各40例,两组常规治疗相同,对A组采用nCPAP给氧治疗联合气管插管吸痰,B组采用婴儿型呼吸机机械通气。观察血气分析动态检测,治疗效果、平均呼吸支持时间和平均住院天数、治疗费用及不良反应。结果:A组患儿在改善通气有明显效果,能取得纠正Ⅱ型呼吸衰竭的治疗效果,但弱于B组改善通气效果。两组治愈率相似,两组呼吸支持时间和平均住院时间相近;治疗费用A组低于B组,经统计学比较存在显著性差异(P<0.01)。结论:nCPAP+气管插管吸痰治疗小婴儿重症肺炎合并Ⅱ型呼吸衰竭安全有效,技术要求较低,容易在基层医院推广。

Objective ：To explore the effect and safety of nasal continuous positive airway pressure （nCPAP） joint tracheal intubation sucking phlegm for little babies with severe pneumonia and Type Ⅱ respiratory failure. Methods：Choose 80 cases of little babies with severe pneumonia and Type II respiratory failure. They were randomly divided into nCPAP ＋ tracheal intubation sucking phlegm group（ A group） and tracheal intubation mechanical ventilation （B group） ,40 cases in each group, with the same routine therapy. Group A with the oxygen treatment by nCPAP joint tracheal intubation sucking phlegm, Group B with infantile breathing machine mechanical ventilation. To observe blood gas analysis dynamic test, the treatment effect, the average time respiratory support and the average days in hospital, the expense and adverse reaction. Results：Group A had obvious effect in improving ventilation to obtain effect on the treatment of Typell respiratory failure, but weaker than in Group B in improving ventilation. The cure rate of the two groups were similar; the respiratory support time and the average days in hospital were close. But the treatment of Group A costs less than that of Group B, with statistic significance （P 〈 0.01 ）. Conclusion：NCPAP ＋ tracheal intubation sucking phlegm in treating little babies with severe pneumonia and Type Ⅱ respiratory failure is safe and effective, the technical requirement is lower. It is easy to promote in basic-level hospitals.