加温湿化高流量鼻导管通气优先策略在婴幼儿重症毛细支气管炎治疗中的应用

Application of high flow nasal catheter ventilation priority strategy in infants with severe bronchiolitis

目的探讨加温湿化高流量鼻导管通气优先策略在婴幼儿重症毛细支气管炎治疗中的疗效和安全性。方法选择2019年1月至2020年12月佛山市高明区人民医院收治的重症毛细支气管炎患儿60例,根据抽签法将其分为两组,每组30例。两组患儿都给予常规治疗,对照组在常规治疗基础上给予排痰、雾化吸入、吸氧等措施,观察组在对照组治疗基础上采用加温湿化高流量鼻导管通气(HHHFNC)。治疗7 d后,比较两组临床疗效、血气指标、并发症。结果治疗7 d后,观察组总有效率(96.67%)高于对照组(73.33%),差异有统计学意义(P<0.05)。治疗24 h后,两组动脉血氧分压(PaO_(2))、PaO_(2)/吸入氧浓度(FiO_(2))均较治疗前上升,PaCO_(2)水平较治疗前下降,且观察组水平较对照组变化显著,差异有统计学意义(P<0.05)。治疗期间,观察组并发症发生率(6.67%)低于对照组(26.67%),差异有统计学意义(P<0.05)。结论HHHFNC优先策略在治疗婴幼儿重症毛细支气管炎时效果显著,可改善血气指标,降低并发症发生率。

Objective To investigate the efficacy and safety of high flow nasal catheter ventilation priority strategy in infants with severe bronchiolitis.Methods Sixty children with severe bronchiolitis admitted to the People’s Hospital of Gaoming District from January 2019 to December 2020 were selected and divided into two groups,with 30 cases in each group.Both groups were given conventional treatment,and the control group was given sputum excretion,atomization inhalation,oxygen inhalation and other measures on the basis of conventional treatment,and the observation group was given high flow nasal catheter ventilation(HHHFNC)on the basis of the control group.After 7 days of treatment,the clinical efficacy,blood gas index and complications were compared between the two groups.Results After 7 days of treatment,the total effective rate of the observation group was 96.67%,which was higher than that of the control group(73.33%,P<0.05).After 24 h of treatment,the arterial oxygen partial pressure(PaO_(2))and PaO_(2)/inhaled oxygen concentration(FiO_(2))in both groups increased compared with that before treatment,and PaCO_(2) level decreased compared with that before treatment,and the level in the observation group changed significantly compared with the control group,with significant difference(P<0.05).During the treatment,the incidence of complications in the observation group(6.67%)was lower than that in the control group(26.67%),with significant difference(P<0.05).Conclusions HHHFNC priority strategy is effective on severe bronchiolitis in infants and young children,improving blood gas indicators and reducing the incidence of complications.