小儿重症肺炎的流行病学特点及持续性气道正压通气治疗的影响因素分析

Epidemiological characteristics of severe pneumonia in children and analysis of influencing factors of continuous positive airway pressure therapy

目的分析小儿重症肺炎的流行病学特点和鼻塞式持续性气道正压通气(CPAP)治疗的影响因素。方法选取2018年4月至2020年5月于本院就诊的129例小儿重症肺炎患儿作为研究对象,其中应用CPAP治疗的患儿作为CPAP组(n=73例),未应用CPAP治疗的患儿作为非CPAP组(n=56)。分析小儿重症肺炎患儿流行病学特点,采用多因素Logistic回归分析应用CPAP治疗的影响因素。结果小儿重症肺炎发病年龄以<3岁为主,占比61.24%;秋季为疾病最高发季节,占比47.29%;症状以咳嗽为主,占比95.35%;CT表现多为单肺叶炎性改变,占比72.09%;预后情况多为生存,占比87.60%。单因素分析结果显示,多个器官功能障碍或衰竭、心力衰竭合并呼吸衰竭、先天性心脏病是CPAP治疗的影响因素(P<0.05)。经多因素Logistic回归分析显示,多个器官功能障碍或衰竭、心力衰竭合并呼吸衰竭、先天性心脏病CPAP治疗的危险因素(OR>1,P<0.05)。结论小儿重症肺炎流行病学特点为发病年龄小,秋冬患病率高,并以咳嗽、喘鸣音症状为主,病死率低,且先天性心脏病、多个器官功能障碍或衰竭、先天性心脏病为小CPAP治疗的危险因素,临床应实施干预措施,进一步预防患病风险。

Objective To analyze the epidemiological characteristics of severe pneumonia in children and analysis of influencing factors of continuous positive airway pressure(CPAP)therapy.Methods 129 children with severe pneumonia admitted to our hospital from April 2018 to May 2020 were selected as the research subjects,among which the children treated with CPAP were included in the CPAP group(n=73),and the children not treated with CPAP were included in the non-CPAP group(n=56).To analyze the epidemiological characteristics of children with severe pneumonia.multivariate Logistic regression was used to analyze the influencing factors of CPAP therapy.Results The onset age of severe pneumonia in infants was less than 3 years old,accounting for 61.24%;autumn was the highest incidence season,accounting for 47.29%;cough was the main symptom,accounting for 95.35%;CT showed monoblobular inflammatory changes,accounting for 72.09%.The prognosis was mostly survival,accounting for 87.60%.The results of factor analysis showed that multiple organ dysfunction or failure,heart failure combined with respiratory failure and congenital heart disease were the influencing factors of CPAP treatment(P<0.05).Multiple Logistic regression analysis showed that multiple organ dysfunction OR failure,heart failure combined with respiratory failure,congenital heart disease CPAP therapy risk factors(OR>1,P<0.05).Conclusion The epidemiological characteristics of severe pneumonia in children are young age of onset,high prevalence in autumn and winter,mainly cough and wheezing symptoms,and low mortality,congenital heart disease,multiple organ dysfunction or failure,and congenital heart disease are risk factors for small CPAP treatment,clinical intervention measures should be implemented to further prevent the risk of disease.