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的应用研究

Application of Warm Humidification and High Flow Nasal Duct 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治疗婴幼儿重症毛细支气管炎的疗效及安全性。方法:选择我院于2019年3月至2021年3月收治的重症毛细支气管炎的婴幼儿,采用随机数表的形式,将患儿随机分为试验组和对照组,对照组采用常规治疗,试验组应用加温湿化高流量鼻导管通气优先策略,观察比较两组患儿经治疗干预后的治疗有效率与并发症,比较两组患儿治疗前后的动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))、心率及呼吸频率。结果:加温湿化高流量鼻导管通气优先治疗的患儿治疗总有效率显著高于对照组(P<0.05),加温湿化高流量鼻导管通气优先治疗的患儿并发症发生率明显低于对照组(P<0.05),且加温湿化高流量鼻导管通气优先治疗的患儿的PaO_(2)、PaO_(2)/FiO_(2)均明显高于对照组;加温湿化高流量鼻导管通气优先治疗的患儿的PaCO_(2)、心率及呼吸频率均明显低于对照组(P<0.05)。结论:加温湿化高流量鼻导管通气优先策略治疗婴幼儿重症毛细支气管炎的疗效更好,安全性更高。

Objective:To investigate the efficacy and safety of warm humidification and high-flow nasal catheter ventilation in the treatment of infants with severe bronchiolitis.Methods:Select our hospital from March 2019 to March 2021 were severe capillary bronchitis infants and young children,in the form of stochastic indicator,the children were randomly divided into trial group and control group,control group using conventional treatment,treatment group application plus temperature humidity to high flow ventilation nasal catheter priority strategy,compare two groups of children after treatment intervention after the treatment effectiveness and complications,The arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(PaO_(2)/FiO_(2)),heart rate and respiratory rate were compared between the two groups before and after treatment.Results:The total effective rate of the children with warm humidified high-flow nasal catheter ventilation was significantly higher than that of the control group(P<0.05),and the complication rate of the children with warm humidified high-flow nasal catheter ventilation was significantly lower than that of the control group(P<0.05).In addition,PaO_(2) and PaO_(2)/FiO_(2) in the children treated with warm humidification and high flow nasal duct ventilation were significantly higher than those in the control group.PaCO_(2),heart rate and respiratory rate of the children treated with warm humidification and high flow nasal duct ventilation were significantly lower than those of the control group(P<0.05).Conclusion:The priority strategy of warm humidification and high flow nasal catheter ventilation has better efficacy and safety in the treatment of infants with severe bronchiolitis.