小儿毛细支气管炎持续正压通气治疗失败的影响因素

Influencing Factors of Continuous Positive Pressure Ventilation Failure in Children with Bronchiolitis

目的分析小儿毛细支气管炎持续正压通气(cPAP)治疗失败的影响因素。方法选取2017年1月至2020年12月夏邑县妇幼保健院收治的35例cPAP治疗成功的毛细支气管炎患儿作为成功组;选择同期夏邑县妇幼保健院收治的35例cPAP治疗失败的毛细支气管炎患儿作为失败组。收集患儿临床资料,分析小儿毛细支气管炎cPAP治疗失败的影响因素。结果两组患儿出生体质量、病原类型、合并肝肾功能异常、发热情况、白细胞计数、中性粒细胞百分比、血红蛋白浓度、降钙素原水平比较,差异均无统计学意义(P>0.05);失败组患儿出生孕周、母乳喂养时间短于成功组,合并先天性心脏病比例高于成功组,差异均有统计学意义(P<0.05)。logistic回归分析显示,合并先天心脏病是影响小儿毛细支气管炎cPAP治疗效果的危险因素(OR>1,P<0.05);出生孕周大、母乳喂养时间长是影响小儿毛细支气管炎cPAP治疗效果的保护因素(OR<1,P<0.05)。结论出生孕周、母乳喂养时间、合并先天性心脏可能为小儿毛细支气管炎cPAP治疗失败的影响因素。

Objective To analyze the influencing factors of treatment failure of continuous positive pressure ventilation(cPAP)in children with bronchiolitis.Methods Thirty-five children with bronchiolitis successfully treated with cPAP in Xiayi Maternal and Child Health Hospital from January 2017 to December 2020 were selected as the success group.Thirty-five children with bronchiolitis who failed cPAP treatment in Xiayi Maternal and Child Health Hospital in the same period were selected as the failure group.The clinical data of children were collected to analyze the influencing factors of cPAP treatment failure in children with bronchiolitis.Results There was no significant difference in birth weight,pathogen type,liver and kidney dysfunction,fever,leukocyte count,percentage of neutrophils,hemoglobin concentration and procalcitonin level between the two groups(P>0.05).The birth gestational weeks and breastfeeding time of children in the failure group were shorter than those in the success group,and the proportion of children with congenital heart disease was higher than that in the success group(P<0.05).Logistic regression analysis showed that congenital heart disease was a risk factor for the therapeutic effect of cPAP in children with bronchiolitis(OR>1,P<0.05).Large gestational age and long breastfeeding time were the protective factors for the therapeutic effect of cPAP in children with bronchiolitis(OR<1,P<0.05).Conclusion Gestational weeks,breastfeeding time and congenital heart may be the influencing factors of cPAP treatment failure in children with bronchiolitis.