经鼻持续气道正压通气技术在婴幼儿重症肺炎治疗中的临床疗效评估

Clinical assessment of nasal continuous positive airway pressure(NCPAP) treating infants with severe pneumonia

目的探讨经鼻持续气道正压通气(NCPAP)在重症肺炎患儿中的临床应用效果。方法选择我院小儿呼吸内科诊断为重症肺炎的病例共106例,随机抽取53例(2016年10月—2017年11月)设为对照组,53例(2017年12月—2018年10月)作为NCPAP组。对照组给予鼻导管给氧,NCPAP组通过鼻腔持续正压通气给氧,比较2组治疗前后呼吸频率、心率和血气分析的变化;临床症状(呼吸困难)、体征(心率、肺部啰音)缓解时间及肺炎严重指数(pneumonia severity index, PSI)变化情况。结果对照组治疗前后呼吸频率,心率和血气分析无明显变化,NCPAP组患儿心率、呼吸频率、二氧化碳分压明显降低,氧分压、血氧饱和度明显升高;与对照组相比,NCPAP组患儿临床症状及体征缓解时间明显缩短,肺炎严重指数明显降低。结论 NCPAP可有效缓解重症肺炎患儿的呼吸困难,值得在基层医院推广。

Objective To study the clinical application of nasal continuous positive airway pressure(NSPAP)in infants with severe pneumonia.Methods 106 infants,diagnosed with severe pneumonia in the department of pediatrics in Qianjiang District ,were equally divided into control group(admitted in hospital from October 2016 to November 2017)and NCPAP(admitted in hospital from December 2017 to October 2018)group by random,and were enrolled in the retrospect program.Nasal canal oxygen was provided to infants in control group while NCPAP in NCPAP group. Changes of before and after treatment in breath rate,heart rate ,blood gas analysis,clinical symptom(dyspnea),signs (heart rate,lung vocal)and PSI score were compared. Statistical software was used for analysis.Results The respiratory rate,heart rate and blood gas analysis of the control group were not significantly changed before and after treatment in control group. The respiratory rate ,heart rate and the carbon dioxide partial pressure of the children in the NCPAP group were significantly decreased after treatment,and the oxygen partial pressure and oxygen saturation were significantly increased. Compared with the control group,the clinical symptoms (dyspnea)and clinical signs(heart rate,lung vocal)relief time of children with NCPAP were significantly shortened,and the PSI score were significantly decreased.Conclusion NCPAP can effectively alleviate the dyspnea of severe pneumonia in infants with severe pneumonia,which is worthy of clinical promotion in district hospital and regional hospital.