加温湿化鼻导管高流量通气治疗婴儿重度社区获得性肺炎的临床效果

Clinical effect of hyperthermia ventilation with moist humidifying nasal catheter in the treatment of infants with severe community acquired pneumonia

目的探讨加温湿化鼻导管高流量通气(HHHFNC)治疗婴儿重度社区获得性肺炎(CAP)的临床效果。方法选择2016年6月～2018年6月我院收治的CAP 60例患儿,随机分为对照组和治疗组,每组各30例。对照组予经鼻持续正压通气(CPAP)治疗;治疗组予HHHFNC治疗。治疗结束后比较两组临床效果、症状与体征消失时间、血流动力学指标及不良反应发生情况。结果治疗后两组氧分压(PaO_2)、脉搏血氧饱和度(SpO_2)升高,二氧化碳分压(PaCO_2)、呼吸频率(RR)、心率(HR)降低(P<0.05);治疗后治疗组的总有效率(93.33%)高于对照组(63.33%),差异有统计学意义(P<0.05),治疗组的退热时间、咳嗽消失时间、肺部湿性啰音消失时间短于对照组,PaO_2、SpO_2高于对照组,PaCO_2、RR、HR低于对照组,差异均有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 HHHFNC治疗婴儿CAP的临床效果显著,能改善患儿的血流动力学,安全有效。

Objective To explore the clinical effect of hyperthermia ventilation with moist humidifying nasal catheter(HHHFNC)in the treatment of infants with severe community acquired pneumonia.(CAP).Methods Artogether 60 infants with CAP in our hospital from June 2016 to June 2018 were selected and randomly divided into two groups,30 cases in each group.The control group were received nasal continuous positive pressure ventilation(CPAP)treatment,and the treatment group received HHHFNC treatment.After treatment,the clinical effect,disappearance time of symptoms and signs,hemodynamic indexes and adverse reactions of the two groups were compared.Results Compared with before treatment,two groups of PaO2,SpO2,PaCO2,RR and HR decreased(P<0.05).After treatment,the total effective rate in the treatment group(93.33%)after treatment was higher than that in the control group(63.33%),the difference was statistically significant(P<0.05),the time of fever,the disappearance of cough and the disappearance of wet rale in the treatment group were shorter than those in the control group,levels of PaO2 and SpO2 were higher than those in the control group,PaCO2,RR and HR were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion HHHFNC is effective and safe in the treatment of CAP in infants,which can improve the hemoclynamics of children.