早期持续气道正压通气在小儿重症肺炎合并呼吸衰竭治疗中的价值研究

Study on Emergency First Aid Countermeasures for Pediatric Severe Pneumonia Complicated with Respiratory Failure

目的分析在常规急救措施的基础上联合早期持续气道正压通气在小儿重症肺炎合并呼吸衰竭治疗中的临床价值。方法回顾性收集2021年8月至2022年8月中山市博爱医院收治的64例小儿重症肺炎合并呼吸衰竭患者临床资料,根据是否进行早期正压通气分为观察组(常规急救措施联合早期正压通气)和对照组(常规急救措施),每组各32例。比较临床症状改善所需时长及住院时长,血气指标,临床疗效,安全性。结果观察组患儿相关临床症状缓解所需时长(P<0.001)和住院总时长(P<0.001)均比对照组短。治疗后,两组血气相关指标均改善(P<0.05);观察组患者血氧分压和血氧饱和度水平高于对照组(P<0.05),二氧化碳分压水平低于对照组(P<0.05)。观察组患者临床疗效优于对照组(P<0.05)。观察组2例(6.25%)出现不良反应,对照组8例(25.00%)出现不良反应,观察组安全性优于对照组(P<0.05)。结论对于合并呼吸衰竭的小儿重症肺炎患者,早期持续气道正压通气可显著缩短临床症状改善所需时长及住院时长,有利于血气指标的改善,且临床疗效显著,安全性高。

Objective To analyze the clinical value of combining early continuous positive airway pressure(CPAP)with conventional emergency measures in the treatment of pediatric severe pneumonia complicated by respiratory failure.Methods A retrospective analysis was conducted on clinical date from 64 pediatric patients with severe pneumonia and respiratory failure admitted to Zhongshan Bo'ai Hospital from August 2021 to August 2022 was conducted.Patients were divided into an observation group(conventional emergency measures combined with early CPAP)and a control group(conventional emergency measures)based on whether early CPAP was administered,32 cases in each group.The duration of symptom relief and hospitalization,blood gas parameters,clinical efficacy,and safety were compared between the two groups.Results The observation group showed a significantly shorter duration for the relief of clinical symptoms(P<0.001)and total hospitalization time(P<0.001)compared to the control group.After treatment,blood gas parameters in both groups improved,with the observation group exhibiting higher levels of partial pressure of oxygen and oxygen saturation(P<0.05)and lower levels of partial pressure of carbon dioxide(P<0.05)compared to the control group.The clinical efficacy in the observation group was superior to that in the control group(P<0.05).Adverse reactions occurred in 2 patients(6.25%)in the observation group and in 8 patients(25.00%)in the control group,with the observation group demonstrating better safety(P<0.05).Conclusions Early continuous positive airway pressure can significantly shorten the duration for clinical symptom relief and hospitalization in pediatric patients with severe pneumonia complicated by respiratory failure,improving blood gas parameters,with marked clini cal efficacy and high safety.