摘要
目的 比较两种无创正压通气治疗轻度急性呼吸窘迫综合征(ARDS)患儿的疗效并分析其影响因素。方法 选择榆阳区人民医院儿童重症医学科2019年1月至2020年12月间收治的112例轻度ARDS患儿为研究对象,采用随机数表法分为对照组和研究组,每组56例,对照组患儿采用经鼻持续气道正压通气治疗,研究组患儿采取无创双水平气道正压通气治疗。比较两组患儿治疗前后的二氧化碳分压(PCO_(2))、动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))、肺动脉压力(PAP)等血气指标变化,以及通气时间、呼吸暂停症状消失时间、住院时间、通气失败率和呼吸暂停发作率,采用Logistic回归分析法分析影响通气失败的因素。结果 治疗前,两组患儿的PaCO_(2)、PaO_(2)、PaO_(2)/FiO_(2)、PAP比较差异均无统计学意义(P>0.05);治疗后,研究组患儿的PaCO_(2)和PAP分别为(44.24±4.26) mm Hg、(37.54±4.98) mmHg,明显低于对照组的(47.46±4.87) mm Hg、(41.22±4.64) mmHg,PaO_(2)和PaO_(2)/FiO_(2)分别为(80.01±5.17) mm Hg、(311.42±22.57) mmHg,明显高于对照组的(76.41±5.24) mmHg、(258.64±20.13) mmHg,差异均有统计学意义(P<0.05);治疗后,研究组患儿的呼吸暂停症状消失时间为(46.33±4.35) h,早于对照组的(50.74±5.18) h,呼吸暂停再发率为16.07%,明显低于对照组的32.14%,差异均有统计学意义(P<0.05);两组患儿的通气时间和通气失败率比较差异均无统计学意义(P>0.05);采用Logistic回归分析结果显示,胎龄、体质量及分娩前激素使用情况为影响通气失败的危险因素(P<0.05)。结论 无创正压通气是治疗轻度ARDS患儿的有效手段,相较于经鼻持续气道正压通气,双水平气道正压通气对ARDS患儿的疗效更优,临床治疗时应充分考虑相关影响因素并结合医院实际情况,给予ARDS患儿最优的治疗方案。
Objective To compare the efficacy of two kinds of noninvasive positive pressure ventilation in the treatment of children with mild acute respiratory distress syndrome(ARDS). Methods A total of 112 children with mild ARDS treated in the Department of Pediatric Critical Medicine, Yuyang District People’s Hospital from January2019 to December 2020 were selected as the research objects. They were randomly divided into a control group and a study group, with 56 children in each group. The control group was treated with nasal continuous positive airway pressure ventilation, and the study group was treated with noninvasive Bi level positive airway pressure ventilation. The changes of blood gas indexes such as partial pressure of carbon dioxide(PCO_(2)), partial pressure of arterial oxygen(PaO_(2)), oxygenation index(PaO_(2)/FiO_(2)), pulmonary artery pressure(PAP), ventilation time, disappearance time of apnea symptoms, hospitalization time, ventilation failure rate, and apnea attack rate were compared between the two groups before and after treatment, and the influencing factors of ventilation failure were analyzed. Results Before treatment,there was no significant difference in PaCO_(2), PaO_(2), PaO_(2)/FiO_(2), PAP between the two groups(P>0.05);After treatment,PaCO_(2)and PAP in the study group were(44.24±4.26) mm Hg,(37.54±4.98) mmHg, significantly lower than(47.46±4.87) mm Hg,(41.22±4.64) mm Hg in the control group, while PaO_(2), PaO_(2)/FiO_(2)in the study group were(80.01±5.17) mm Hg,(311.42±22.57) mm Hg, significantly higher than(76.41±5.24) mmHg,(258.64±20.13) mm Hg in the control group(P<0.05). The disappearance time of apnea symptoms in the study group was(46.33±4.35) h, which was earlier than(50.74±5.18) h in the control group, and the recurrence rate of apnea was 16.07%, significantly lower than 32.14% in the control group, with statistically significant difference(P<0.05). There was no significant difference in ventilation time and failure rate between the two groups(P>0.05). Logistic regres
作者
李芳
王波
LI Fang;WANG Bo(Department of Pediatric Critical Care Medicine,People's Hospital of Yuyang District,Yulin 719000,Shaanxi,CHINA;Department of Pediatrics,People's Hospital of Yuyang District,Yulin 719000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2022年第6期758-761,共4页
Hainan Medical Journal
关键词
无创正压通气
新生儿
轻度
急性呼吸窘迫综合征
疗效
危险因素
Noninvasive positive pressure ventilation
Newborn
Light
Acute respiratory distress syndrome
Efficacy
Risk factors
