经鼻高流量氧疗治疗儿童重症呼吸道合胞病毒肺炎的临床效果

Clinical effect of nasal high flow oxygen therapy in the treatment of severe respiratory syncytial virus pneumonia in children

目的观察经鼻高流量氧疗(HFNC)治疗儿童重症呼吸道合胞病毒(RSV)肺炎的临床效果。方法回顾性选取2019年1月—2022年6月福建省厦门市儿童医院PICU收治的重症RSV肺炎患儿92例,根据治疗方法不同分为观察组40例和对照组52例,观察组给予HFNC治疗,对照组给予常规氧疗,2组均治疗48 h。比较2组患儿临床疗效、入住PICU住院时间、总住院时间,治疗前后动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH值、心率(HR)、呼吸频率(RR)。结果治疗48 h后,观察组患儿总有效率为90.00%,高于对照组的73.08%(χ^(2)=4.114,P=0.043);观察组患儿入住PICU时间长于对照组(P<0.05),但2组患儿总住院时间比较差异无统计学意义(P>0.05);治疗48 h后,2组患儿PaO_(2)均高于治疗前,HR及RR均低于治疗前,且观察组PaO_(2)高于对照组,RR低于对照组(P<0.05),2组患儿治疗前后pH值、PaCO_(2)比较差异均无统计学意义(P>0.05)。结论HFNC治疗儿童重症RSV肺炎的临床效果较好,可明显改善患儿临床症状、血气指标及生命体征,缓解呼吸困难,值得应用。

Objective To observe the clinical effect of nasal high-flow oxygen therapy(HFNC)in the treatment of severe respiratory syncytial virus(RSV)pneumonia in children.Methods A total of 92 children with severe RSV pneumonia admitted to PICU of Xiamen Children′s Hospital from January 2019 to June 2022 were retrospectively selected and divided into observation group(n=40)and control group(n=52)according to different treatment methods.The observation group was treated with HFNC,while the control group was treated with conventional oxygen therapy,both groups were treated for 48 hours.The clinical efficacy,length of stay in PICU,total length of stay,arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),pH value,heart rate(HR),respiratory rate(RR)before and after treatment were compared between the two groups.Results After 48 hours of treatment,the total effective rate of the observation group was 90.00%,which was higher than 73.08%of the control group(χ^(2)=4.114,P=0.043).The duration of PICU stay in the observation group was longer than that in the control group(P<0.05),but there was no significant difference in the total hospital stay between the two groups(P>0.05).After 48 h of treatment,the PaO_(2)of the two groups were higher than before treatment,HR and RR were lower than before treatment,and the PaO_(2)of the observation group was higher than control group,RR was lower than control group(P<0.05),there were no significant difference in pH and PaCO_(2)between two groups before and after treatment(P>0.05).Conclusion HFNC has a good clinical effect in the treatment of children with severe RSV pneumonia,which can significantly improve the clinical symptoms,blood gas indexes and vital signs,and relieve dyspnea,which is worthy of application.