经湿化高流量鼻导管通气对婴儿重症肺炎辅助治疗效果及对临床症状消失时长的影响分析

Analysis of the Effect of Transhygroscopic High-flow Nasal Cannula Ven⁃tilation on the Adjuvant Treatment of Severe Pneumonia in Infants and the Effect on the Duration of Clinical Symptoms Disappearance

目的研究经湿化高流量鼻导管通气对婴儿重症肺炎辅助治疗效果及对临床症状消失时长的影响。方法方便选取2019年12月—2021年12月山东省淄博市妇幼保健院收治的150例重症肺炎患儿展开研究,按照随机数字表法分为观察组和对照组。在常规治疗的基础上,对照组75例实施经鼻持续气道正压通气治疗,观察组75例实施经湿化高流量鼻导管通气治疗。比较两组的血气分析指标、生命体征指标、临床疗效、并发症发生情况、临床症状消失时间及住院时间。结果治疗后,观察组患儿的PaO_(2)(83.54±11.20)mmHg、SaO_(2)(96.42±3.01)%、MAP(89.16±7.65)mmHg、PaCO_(2)(40.25±3.06)mmHg、RR(45.52±2.38)次/min、HR(120.42±10.65)次/min与对照组相比较,差异有统计学意义(t=7.229、9.408、8.893、9.290、11.944、6.047,P<0.05);观察组的临床总有效率(97.33%)高于对照组,并发症发生率(2.67%)低于对照组,差异有统计学意义(χ^(2)=7.878、4.807,P<0.05);观察组的呼吸困难消失时间(1.04±0.24)d、肺部啰音消失时间(3.46±1.10)d、心率恢复正常时间(3.11±1.13)d、PICU住院时间(6.67±1.53)d、总住院时间(9.08±1.88)d均短于对照组,差异有统计学意义(t=9.847、8.928、10.213、6.179、11.076,P<0.05)。结论经湿化高流量鼻导管通气治疗安全有效,能使重症肺炎患儿的病情快速、有效的恢复。

Objective To study the effect of transhygroscopic high-flow nasal cannula ventilation on the adjuvant treat⁃ment effect of severe pneumonia in infants and the effect on the length of disappearance of clinical symptoms.Methods convenient selection 150 cases of children with severe pneumonia admitted to Zibo Maternal and Child Health Hospital in Shandong Province from December 2019 to December 2021 were selected for the study,and divided into observation group and control group according to the random number table method.On the basis of conventional treatment,75 cases in the control group were treated with transnasal continuous positive airway pressure ventilation,and 75 cases in the observation group were treated with transwetted high-flow nasal cannula ventilation.The blood gas analysis in⁃dexes,vital signs indexes,clinical efficacy,complications,disappearance time of clinical symptoms and hospitalization time of the two groups were compared.Results After treatment,PaO_(2)(83.54±11.20)mmHg,SaO_(2)(96.42±3.01)%,MAP(89.16±7.65)mmHg,PaCO_(2)(40.25±3.06)mmHg,RR(45.52±2.38)times/min,HR(120.42±10.65)times/min of the children in the observation group compared with the control group,and the differences were statistically significant(t=7.229,9.408,8.893,9.290,11.944,6.047,P<0.05).The total clinical efficiency(97.33%)of the observation group was higher than that of the control group,and the complication rate(2.67%)was lower than that of the control group,the difference was statistically significant(χ^(2)=7.878,4.807,P<0.05).The time to disappearance of dyspnea(1.04±0.24)d,time to disappearance of pulmonary rales(3.46±1.10)d,time to return to normal heart rate(3.11±1.13)d,time to PICU stay(6.67±1.53)d,and total hospital stay(9.08±1.88)d were shorter in the observation group than in the con⁃trol group,and the difference was statistically significant(t=9.847,8.928,10.213,6.179,11.076,P<0.05).Conclusion Transhygroscopic high-flow nasal cannula ventilation therapy was safe and effective,and children with severe pneumo⁃nia recovered rapidly and effectively.