重症肺炎合并呼吸衰竭患儿经鼻持续气道正压通气呼吸机联合酚妥拉明治疗临床探讨

Clinical Study on the Treatment of Nasal Continuous Positive Airway Pressure Ventilator Combined with Phentolamine in Children with Severe Pneumonia and Respiratory Failure

目的观察重症肺炎合并呼吸衰竭患儿行酚妥拉明联合经鼻持续气道正压通气呼吸机治疗的效果。方法选取2019年5月—2020年5月云南省滇南中心医院收治的88例重症肺炎合并呼吸衰竭患儿,依据入院编号分组,联合组44例行酚妥拉明联合经鼻持续气道正压通气治疗,普通组44例仅行经鼻持续气道正压通气治疗,观察两组炎性指标、血气指标及治疗效果。结果联合组治疗前IL-6(94.37±5.88)pg/mL、CRP(45.75±5.62)mg/mL、PCT(9.04±3.22)μg/L与普通组比较,差异无统计学意义(t=0.092、0.321、0.101,P>0.05)。联合组治疗后白细胞介素-6(IL-6)(21.33±4.76)pg/mL、C反应蛋白(CRP)(11.82±3.04)mg/mL、降钙素原(PCT)(1.03±0.41)μg/L优于普通组,差异有统计学意义(t=18.736、10.511、11.585,P<0.05)。联合组治疗前PaO2(45.33±7.69)mmHg、SaO2(73.96±5.14)%、PaCO2(56.93±7.14)mmHg与普通组比较,差异无统计学意义(t=0.044、0.072、0.322,P>0.05)。联合组治疗后PaO2(82.50±5.17)mmHg、SaO2(91.75±4.40)%、PaCO2(41.07±3.58)mmHg优于普通组,差异有统计学意义(t=7.210、6.620、8.006,P<0.05)。联合组治疗有效率(95.45%)较普通组(77.27%)更高,差异有统计学意义(χ^(2)=6.175,P=0.013)。结论重症肺炎合并呼吸衰竭患儿行酚妥拉明联合经鼻持续正压通气治疗后,炎性指标及血气指标改善明显,建议推广。

Objective To observe the effect of phentolamine combined with continuous positive airway pressure ventilation in children with severe pneumonia and respiratory failure.Methods From May 2019 to May 2020,88 children with severe pneumonia combined with respiratory failure in Yunnan Province South Central Hospital were selected and grouped according to the admission number.44 cases in the combined group received phentolamine combined with continuous positive airway pressure through the nose ventilation treatment,44 cases of the normal group received only continuous positive airway pressure through the nose,and the inflammatory indexes,blood gas indexes and the treatment effect of the two groups were observed.Results Before treatment,there was no significnat difference in IL-6(94.37±5.88)pg/mL,CRP(45.75±5.62)mg/mL,PCT(9.04±3.22)μg/L of the combined group and the normal group(t=0.092,0.321,0.101,P>0.05).After treatment in the combined group,IL-6(21.33±4.76)pg/mL,CRP(11.82±3.04)mg/mL,and PCT 1.03±0.41)μg/L were better than the normal group.The difference was statistically significant(t=18.736,10.511,11.585,P<0.05).Before treatment,there was no significant difference in PaO2(45.33±7.69)mmHg,SaO2(73.96±5.14)%,and PaCO2(56.93±7.14)mmHg of the combined group and the normal group(t=0.044,0.072,0.322,P>0.05).PaO2(82.50±5.17)mmHg,SaO2(91.75±4.40)%,and PaCO2(41.07±3.58)mmHg in the combined group were better than the normal group after treatment.The difference was statistically significant(t=7.210,6.620,8.006,P<0.05).The effective rate of treatment in the combination group(95.45%)was higher than that of the normal group(77.27%).The difference was statistically significant(χ^(2)=6.175,P=0.013).Conclusion After phentolamine combined with nasal continuous positive pressure ventilation in children with severe pneumonia combined with respiratory failure,the inflammatory indexes and blood gas indexes improved significantly,and it is recommended to promote it.