摘要
目的探讨分析鼻塞式双相气道正压(BiPAP)通气在治疗先天性喉喘鸣合并新生儿肺炎中的临床应用。方法选取2018年5月至2019年6月惠州市中心人民医院博罗分院儿科收治的64例先天性喉喘鸣合并新生儿肺炎的患儿,采用计算机表法将其随机分为常规治疗组与BiPAP组,每组32例。男35例,女29例,胎龄(36.46±1.13)周,胎龄范围为32~42周。常规治疗组进行抗感染、翻身拍背、化痰、吸氧等常规治疗,BiPAP组在常规治疗基础上进行同步鼻塞式BiPAP通气治疗,观察比较两组患儿的血气指标情况[pH值、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)]、抗感染治疗时间及住院时间、并发症(气漏综合征、鼻部压迫受伤、鼻中隔坏死)发生率。结果治疗后,BiPAP组治疗后的pH值(7.42±0.05)、PaO2[(93.60±8.90)mmHg,1 mmHg=0.133 kPa]高于常规治疗组[(7.32±0.01)、(74.14±9.25)mmHg],PaCO2[(37.40±2.80)mmHg]低于常规治疗组[(45.58±2.86)mmHg],差异有统计学意义(P<0.05)。BiPAP组患儿的抗感染治疗时间[(6.28±2.91)d]及住院时间[(8.41±3.92)d]短于常规治疗组[(10.14±3.17)d、(12.82±4.67)d]、并发症发生率[6.3%(2/32)]低于常规治疗组[25.0%(8/32)],差异均有统计学意义(P<0.05)。结论通过鼻塞式BiPAP通气对先天性喉喘鸣合并新生儿肺炎患儿进行治疗,能够显著改善血气指标,缩短抗感染治疗时间及住院时间,值得在临床中推广应用。
Objective To investigate the application of nasal-plug biphasic positive airway pressure(BiPAP)ventilation in congenital laryngeal stridor complicated with neonatal pneumonia.Methods A retrospective study was performed on 64 cases of congenital laryngeal wheeze combined with neonatal pneumonia who were admitted from May 2018 to June 2019.Patients were randomly divided into the conventional group and the BiPAP group,with 32 cases in each group.There were 35 males and 29 females,gestational age(36.46±1.13)weeks,and gestational age ranged from 32 to 42 weeks.The conventional treatment group received routine treatment such as anti-infection,turning over and clapping the back,expectoration and oxygen inhalation,while the BiPAP group received synchronous nasal obstruction BiPAP ventilation on the basis of routine treatment.To observe and compare the blood gas indexes of the two groups[pH value,partial pressure of carbon dioxide level in arterial blood(PaCO2),partial pressure of oxygen(PaO2)],duration of anti-infection treatment and hospitalization,and incidence of complications(air leakage syndrome,nasal compression injury and septal necrosis).Results After treatment,the pH value(7.42±0.05),PaO2[(93.60±8.90)mmHg,1 mmHg=0.133 kPa]of BiPAP group were higher than those of routine treatment group[(7.32±0.01),(74.14±9.25)mmHg],PaCO2[(37.40±2.80)mmHg]was lower than that of routine treatment group[(45.58±2.86)mmHg],and the difference was statistically significant(P<0.05).The time of anti-infective treatment[(6.28±2.91)days]and hospitalization[(8.41±3.92)days]in BiPAP group were shorter than those in routine treatment group[(10.14±3.17)days,(12.82±4.67)days],and the incidence of complications[6.3%(2/32)]was lower than that in routine treatment group[25.0%(8/32)],P<0.05.Conclusion The treatment of children with congenital laryngeal wheezing combined with neonatal pneumonia by nasal plug BiPAP ventilation can significantly improve the blood gas index,shorten the anti-infection treatment time and hospitalization time,which is worthy of promotion and application in clinical practice.
作者
陈嵘峰
彭兰
李玲
Chen Rongfeng;Peng Lan;Li Ling(Department of Pediatrics,Boluo Branch,Huizhou Central People′s Hospital,Huizhou 516100,China)
出处
《中国临床实用医学》
2020年第1期15-18,共4页
China Clinical Practical Medicine
基金
广东省惠州市科技局立项(18053011174942)。
关键词
新生儿肺炎
先天性喉喘鸣
鼻塞式双相气道正压通气
抗感染治疗
Neonatal pneumonia
Congenital laryngeal stridor
Nasal plug biphasic positive airway pressure ventilation
Anti-infective treatment
