加温湿化经鼻高流量氧疗治疗小儿重症肺炎的临床研究

Clinical Study on the Treatment of Severe Pneumonia in Children by Hypernasal Oxygen Therapy with Humidification

目的探讨加温湿化经鼻高流量氧疗治疗小儿重症肺炎临床效果。方法随机选取2020年1月—2021年1月福建医科大学附属漳州市医院儿童重症监护病房(pediatric intensive care unit,PICU)收治的104例重症肺炎患儿为研究对象,将其分为观察组与对照组,每组52例。对照组采用一般经鼻导管吸氧治疗,观察组采用加温湿化经鼻高流量氧疗治疗。比较两组患儿治疗前后的呼吸力学指标、血气值变化情况、临床症状好转时间与治疗效果。结果治疗后,观察组的气道阻力与动态顺应性均优于对照组,差异有统计学意义(P<0.05)。治疗后,观察组碳酸氢根与氧分压高于对照组,二氧化碳分压低于对照组,差异有统计学意义(P<0.05)。观察组止咳时间、气促缓解时间、退热时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率96.1%高于对照组的65.4%,差异有统计学意义(P<0.05)。结论加温湿化经鼻高流量氧疗治疗小儿重症肺炎临床效果明显,能够使患儿的临床症状得到改善,对患儿的身体康复有促进作用。

Objective To investigate the clinical effect of hypernasal oxygen therapy for severe pneumonia in children.Methods 104 children with severe pneumonia admitted to the Pediatric Intensive Care Unit(PICU)of Zhangzhou Hospital Affiliated to Fujian Medical University from January 2020 to January 2021 were randomly selected as research subjects and divided into observation group and control group,with 52 cases in each group.The control group was treated with general nasal catheter oxygen therapy,and the observation group was treated with humidifying nasal high flow oxygen therapy.The respiratory mechanical index,blood gas value changes,clinical symptom improvement time and therapeutic effect of the two groups were compared before and after treatment.Results After treatment,the airway resistance and dynamic compliance in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the partial pressure of bicarbonate and oxygen in the observation group were higher than those in the control group,while the fraction of carbon dioxide in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The cough relief time,gasping relief time,fever reduction time and hospital stay time in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).The total effective rate was 96.1%in the observation group,which was higher than that in the control group(65.4%),and the difference was statistically significant(P<0.05).Conclusion The clinical effect of humidification and nasal high flow oxygen therapy in the treatment of severe pneumonia in children is obvious,which can improve the clinical symptoms of children and promote the physical recovery of children.