经鼻加温湿化氧疗在儿童重症肺炎中的疗效分析

Effect analysis of pernasal heated humidified high flow oxygen therapy in treating children with severe pneumonia

目的探讨经鼻加温湿化高流量氧疗(HFNC)在儿童重症肺炎中的疗效。方法分析2016年本院PICU重症肺炎患儿入院后使用HFNC治疗1 h后呼吸频率、心率、动脉氧分压[p(O_2)]、动脉二氧化碳分压[p(CO_2)]变化及插管率、氧疗时间、治愈好转率。结果 HFNC能显著缓解重症肺炎患儿的呼吸频率、心率(P<0.05),显著提高p(O_2)(P<0.05),对合并Ⅱ型呼吸衰竭的患儿还可降低p(CO_2)(P<0.05)。Ⅰ、Ⅱ型呼吸衰竭患儿插管率无显著差异,但显著高于无呼吸衰竭者(P<0.05)。Ⅱ型呼吸衰竭平均氧疗时间为7.38 d,显著长于Ⅰ型呼吸衰竭的5.45 d及无呼吸衰竭者的4.45 d(P<0.05),治愈好转率为100%。结论 HFNC可以有效缓解重症肺炎患儿呼吸频率、心率,改善低氧血症,对于合并Ⅱ型呼吸衰竭的患儿还可显著降低p(CO_2)。

Objective To investigate the clinical effect of pernasal heated humidified high flow oxygen therapy(HFNC)on treating children with severe pneumonia.Methods For the children with severe pneumonia by treatment of HFNC in PICU in 2016,the changes of respiratory rate,heart rate,p(O 2)and p(CO 2)after one hour of HFNC and intubation rate,time of oxygen therapy and curative rate were analyzed.Results The HFNC was able to alleviate the respiratory rate,heart rate and increased p(O 2)significantly(P<0.05),and for children with severe pneumonia complicated with typeⅡrespiratory failure,the HFNC also can reduced p(CO 2)significantly(P<0.05).There was no significant difference of intubation rate between children with typeⅠandⅡrespiratory failure,but both were significantly higher than children without respiratory failure(P<0.05).The mean oxygen therapy time of children with typeⅡrespiratory failure was 7.38 d,which was significantly longer than 5.45 d of children with typeⅠrespiratory failure and 4.45 d of children without respiratory failure(P<0.05).The curative rate was 100%.Conclusion HFNC can effectively relieve the respiratory rate,heart rate and hypoxemia in children with severe pneumonia.It can also significantly reduce p(CO 2)in children with typeⅡrespiratory failure.