经鼻持续气道正压通气对重症肺炎合并呼吸衰竭患儿临床疗效及肺功能的影响研究

Effect of Nasal Continuous Positive Airway Pressure Ventilation on Clinical Efficacy and Pulmonary Function in Children with Severe Pneumonia Complicated with Respiratory Failure

目的:探究经鼻持续气道正压通气对重症肺炎合并呼吸衰竭患儿临床疗效及肺功能的影响。方法:选取2015年7月-2017年11月本院收治的重症肺炎合并呼吸衰竭患儿88例,按照随机数字表法将其分为常规组及通气组,各44例。常规组行常规治疗,通气组行经鼻持续气道正压通气治疗。比较两组治疗前后血气分析指标、肺功能指标、呼吸频率、心率,比较两组治疗效果并记录患儿症状改善时间、住院时间。结果:通气组总有效率为95.45%显著优于常规组的77.27%(X^2=6.175,P=0.013);治疗后,两组Pa O_2及氧合指数均高于治疗前,Pa CO_2、心率及呼吸频率均低于治疗前,且通气组各指标均优于常规组,比较差异均有统计学意义(P<0.05);治疗后,两组FEV_1、FEV_1/FVC、FEV_1占预计值百分比均高于治疗前,FVC均低于治疗前,且通气组各指标均优于常规组,比较差异均有统计学意义(P<0.05);通气组相应症状改善时间及住院时间均显著短于常规组(P<0.05)。结论:对重症肺炎合并呼吸衰竭的患儿采用经鼻持续气道正压通气进行治疗,能够有效改善患儿相应症状,在提高治疗效果及减少治疗时间等方面均有重要意义,且可行性高,值得推广。

Objective：To investigate the effect of nasal continuous positive airway pressure ventilation on clinical efficacy and pulmonary function in children with severe pneumonia complicated with respiratory failure.Method：A total of 88 children with severe pneumonia complicated with respiratory failure in our hospital from July 2015 to November 2017 were selected.According to the random number table method,they were divided into routine group and ventilation group,44 cases in each group.Routine group was treated with routine treatment,and ventilation group was treated by nasal continuous positive airway pressure ventilation.The blood gas analysis index,lung function index,respiratory rate and heart rate before and after treatment between two groups were compared,the treatment effect,symptom improvement time and hospitalization time between two groups were compared.Result：The total effective rate in ventilation group was 95.45%,which was significantly better than 77.27% in routine group（χ^2=6.175,P=0.013）.After treatment,Pa O2 and oxygenation index in two groups were higher than those of before treatment,Pa CO2,heart rate and respiratory frequency were lower than those before treatment,and all indices in ventilation group were better than those of routine group,the differences were statistically significant（P〈0.05）.After treatment,FEV1,FEV1/FVC,FEV1 percentage of expected value were all higher than those before treatment,FVC was lower than that before treatment,and all indices in ventilation group were better than those of routine group,the differences were statistically significant（P〈0.05）.The symptom improvement time and hospitalization time in ventilation group were shorter than those of routine group（P〈0.05）.Conclusion：The treatment of severe pneumonia with respiratory failure by nasal continuous positive airway pressure ventilation can effectively improve the corresponding symptoms of the children.It is of great significance in improving the therapeutic effect and reducing treatment time,and has high feasibility and has been popularized.