NCPAP治疗重症肺炎患儿的临床效果及对其心功能的影响作用观察

Clinical effect of NCPAP in treatment of children with severe pneumonia and its impact on their cardiac function

目的探讨采用经鼻持续气道正压通气(NCPAP)治疗小儿重症肺炎合并心力衰竭患儿的临床效果及对其心功能的影响作用。方法根据就诊顺序将安徽医科大学附属省立医院儿科收治的190例重症肺炎合并心衰患儿分为研究组和对照组各95例,两组患儿均给予综合治疗措施,对照组加用经鼻导管吸氧治疗,研究组加用NCPAP治疗。结果研究组的心率恢复时间、呼吸困难时间、肺部啰音消失时间均显著地短于对照组患儿(P<0.05)。治疗后研究组患儿的Pa O2(7.52±0.86)、Pa CO2(5.62±0.65)、p H值(7.34±0.04)均显著地优于对照组患儿的Pa O2(7.14±0.75)、Pa CO2(5.93±0.58)、p H值(7.31±0.05)(P<0.05)。治疗后研究组患儿的LVEF、E/A、CI改善效果优于对照组患儿(P<0.05)。研究组的好转率85.26%显著地高于对照组患儿的71.58%(P<0.05),研究组的总有效率(95.79%)高于对照组患儿的(92.63%),但差异无统计学意义(P>0.05)。结论采用NCPAP治疗重症肺炎合并心力衰竭患儿能够更显著的改善患儿的血气、心功能指标,治疗效果更好。

Objective To explore the clinical effect of nasal continuous positive airway pressure （NCPAP） in treatment of children with severe pneumonia combined with heart failure and its impact on their cardiac function. Methods A total of 190 children with severe pneumonia combined with heart failure treated in Department of Pediatrics in the hospital were divided into study group and control group according to registration order, 95 children in each group. The children in control group were treated by comprehensive therapy and nasal oxy- gen inhalation, while the children in study group were treated by comprehensive therapy and NCPAP. Results The recovery time of heart rate, dyspnea time, and disappearance time of pulmonary rales in study group were statistically significantly shorter than those in control group （P〈0. 05） . After treatment, PaO2, PaCO2, and pH value in study group were （7. 52±0. 86）, （5.62±0. 65）, and （7.34±0. 04） , respectively, which were statistically significantly better than those in control group [ （7.14±0. 75）, （5.93±0. 58）, and （7.31±0. 05） （ P〈0.05 ） ; the improvement effects of LVEF, E/A, and CI in study group were statistically significantly better than those in control group （ P〈0. 05 ） . The improvement rate in study group was 85.26% , which was statistically significantly higher than that in control group （71.58%） （P〈0. 05） . The total effective rate in study group was 95.79%, which was higher than that in control group （92. 63% ）, but there was no statistically significant difference （P〉0. 05） . Conclusion＇ NCPAP can significantly improve blood gas and cardiac function indexes in treatment of children with severe pneumonia combined with heart failure, the curative effect is good.