重症肺炎并呼吸衰竭患儿早期给予CPAP对血气指标及预后的影响

The effect of CPAP to bloodgas indexes and prognosis in children with severe pneumonia complicated with respiratory failure

目的探讨小儿重症肺炎并呼吸衰竭行早期经鼻持续气道正压通气(CPAP)对血气指标及预后的影响。方法选取2015年6月至2016年6月在我院诊治的68例重症肺炎合并呼吸衰竭患儿,将其随机分为对照组和观察组,各34例。对照组采用常规治疗方案,观察组选用早期经鼻持续气道正压通气治疗。比较两组患儿的预后、血气指标及疗效。结果观察组患儿呼吸困难消失时间、发绀及肺部音消失时间均明显短于对照组(P<0.05);观察组患儿的住院时间和心率恢复正常时间短于对照组(P<0.05)。治疗后两组患儿的pH、PaO_2、PaCO_2及SaO_2均得到改善,观察组患儿的改善程度更为明显(P<0.05);观察组患儿的病死率低于对照组(P<0.05)。结论针对小儿重症肺炎并呼吸衰竭患者,早期采用经鼻持续气道正压通气予以治疗,可显著改善患儿病情及预后。

Objective To investigate the effect of early nasal continuous positive airway pressure （CPAP） to blood gas indexes and prognosis in children with severe pneumonia and respiratory failure. Methods Sixty-eight cases of severe pneumonia children complicated with respiratory failure in our hospital were randomly divided into control group and observation group, with 34 cases in each group. The control group received conventional treatment, while the observation group was treated with early CPAP therapy. The prognosis, blood gas indexes and curative effect of the two groups were compared. Results The dyspnea disappearance time, cyanosis and the disappearing time of lung rales in the observation group were shorter than those in control group （P〈0.05）. The heart rate recovery time and hospital stay in the observation group were shorter than those in control group （P〈0.05）. After treatment, the pH,PaO2,PaC02 and Sa02 were improved in both two groups, and the improvement of these indicators in the observation group were more significant （/~〈0.05）. The death rate in control group was lower than that in observation group （P〈0.05）. Conclusion Early CPAP treatment in children with severe pneumonia and respiratory failure can significantly improve children＇s condition and prognosis.