CPAP与经鼻高流量湿化氧疗治疗婴儿合胞病毒肺炎的效果比较

Effect Comparison of CPAP and Nasal High Flow Humidified Oxygen Therapy in Treatment of Infantile Syncytial Virus Pneumonia

目的比较无创持续正压通气(CPAP)与经鼻高流量湿化氧疗(HHFNC)治疗婴儿合胞病毒肺炎的临床。方法选择2022年4月—2023年3月本院收治的84例婴幼儿重症呼吸道合胞病毒肺炎患儿为研究对象,采用随机数表法将患儿分成CPAP组与HHFNC组,每组42例。两组均给予抗病毒、祛痰止咳、平喘、纠正水电解质紊乱等常规对症治疗,在此基础上,CPAP组采用CPAP治疗,HHFNC组采用湿化高流量鼻导管通气治疗,比较两组治疗前、治疗后6h血气分析结果、症状缓解时间、住院时间、并发症发生情况。结果治疗前两组患儿的PaO_(2)、PaCO_(2)、pH值比较差异无统计学意义(P>0.05);治疗后两组患儿PaO_(2)、PaCO_(2)、pH值均较治疗前有显著改善(P<0.05),但组间差异无统计学意义(P>0.05)。两组患儿氧分压恢复时间、呼吸平稳时间、喘憋缓解时间、肺啰音消失时间、住院时间比较无统计学意义(P>0.05)。HHFNC组气道湿化满意率明显高于CPAP组,呼吸治疗相关并发症总发生率明显低于CPAP组(P<0.05)。结论CPAP与经鼻高流量湿化氧疗在改善婴儿合胞病毒肺炎患儿血气、症状方面效果相对,但高流量鼻导管通气能够减少并发症发生,值得推广应用。

Objective To compare clinical effect of non-invasive continuous positive pressure ventilation(CPAP)and nasal high flow humidified oxygen therapy(HHFNC)in treatment of infantile syncytial virus pneumonia.Methods The paper chose 84 infants and young children with severe respiratory syncytial virus pneumonia admitted to our hospital from April 2022 to March 2023 as study subjects,and divided them into CPAP group and HHFNC group with random number table method,with 42 cases in each group.Both groups were treated with routine symptomatic treatments including antiviral therapy,expectorant and cough relief,asthma relief,and correction of water and electrolyte imbalances.on The basis,CPAP group was treated with CPAP treatment,while HHFNC group with humidified high flow nasal cannula ventilation treatment.Blood gas analysis results,symptom relief time,hospital stay,and incidence of complications before and 6 hours after treatment were compared between two groups.Results Before treatment,there was no statistically significant difference in PaO_(2),PaCO_(2),and pH values between two groups(P>0.05).After treatment,both groups showed more significant improvement in PaO_(2),PaCO_(2),and pH values than before treatment(P<0.05),there was no statistically significant difference between the groups(P>0.05).There was no statistically significant difference in recovery time of oxygen partial pressure,breathing stability time,relief time of wheezing,disappearance time of lung rales,and length of stay between two groups(P>0.05).Satisfaction degree of airway humidification in HHFNC group was significantly higher than CPAP group,and total incidence of respiratory treatment-related complications was significantly lower than CPAP group(P<0.05).Conclusion CPAP and nasal high flow humidified oxygen therapy can achieve relatively good effect in improving blood gas and symptoms of children with infantile syncytial virus pneumonia.However,high flow nasal cannula ventilation can reduce incidence of complications,which is worthy of promotion and application.