人免疫球蛋白辅助经鼻持续气道正压通气对重症肺炎合并呼吸衰竭患儿的影响

Influences of Human Immunoglobulin Combined with Nasal Continuous Positive Airway Pressure on Children with Severe Pneumonia and Respiratory Failure

目的:探讨人免疫球蛋白联合经鼻持续气道正压通气(NCPAP)在重症肺炎合并呼吸衰竭患儿治疗中的应用价值.方法:采用随机数字表法将87例重症肺炎合并呼吸衰竭患儿分为联合组(n=44)和常规组(n=43).联合组采用人免疫球蛋白辅助NCPAP治疗,常规组采用NCPAP治疗.对比两组患儿呼吸、心率、症状改善时间、血氧饱和度(SpO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO_(2))及免疫球蛋白(Ig)A、IgG、IgM及CD4/CD8比值,并统计两组并发症发生率.结果:治疗后,联合组呼吸频率、心率及PaCO_(2)均低于常规组(P<0.05),SpO_(2)、PaO_(2)以及IgA、IgG、IgM及CD4/CD8比值均高于常规组(P<0.05);联合组住院时间、心率恢复正常、呼吸困难缓解、发绀消失、肺部啰音消失时间均明显短于常规组,两组比较,差异均有统计学意义(P<0.05).结论:人免疫球蛋白辅助NCPAP联合治疗可快速缓解重症肺炎合并呼吸衰竭患儿临床症状,改善血气分析各项指标及免疫功能,促进患儿康复.

Objective:To explore the values of human immunoglobulin combined with nasal continuous positive airway pressure(NCPAP)in the treatment of children with severe pneumonia complicated with respiratory failure.Methods:Eighty-seven children with severe pneumonia complicated with respiratory failure were randomly divided into combined group(n=44)and routine group(n=43).The combined group were treated with human immunoglobulinassisted NCPAP and the conventional group were treated with NCPAP.The respiration rate,heart rate,symptom improvement time,the oxygen saturation of blood(SpO_(2)),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),immunoglobulin(Ig)A,IgG,IgM and CD4/CD8 ratio were compared between two groups,and the incidence of complications were recorded.Results:After treatment,the respiratory rate,heart rate and PaCO_(2),in the combined group were lower than those in the conventional group(P<0.05);after the treatment,the SpO_(2),PaO_(2),IgA,IgG,IgM and CD4/CD8 ratio in the combined group were higher than those in the conventional group(P<0.05);the time for the heart rate return to normal,the time for the relief of dyspnea,the disappearance of cyanosis,the disappearance of pulmonary rales and the hospitalization time in the combined group were shorter than those in the conventional group(P<0.05).Conclusion:Human immunoglobulin-assisted NCPAP combined therapy can quickly relieve the clinical symptoms of children with severe pneumonia complicated with respiratory failure,improve blood gas indexes and immune function,and promote the rehabilitation of children.