摘要
目的观察儿科重症监护病房(PICU)重症肺炎患儿采用有创呼吸机联合抗生素阶梯疗法治疗的效果。方法回顾性分析焦作市妇幼保健院2018年1月至2019年6月重症肺炎患儿的资料,将完成有创呼吸机联合抗生素阶梯疗法43例患儿纳入观察组,另抽取同期完成有创呼吸机联合抗生素常规治疗的40例患儿纳入对照组,评估两组治疗7 d的疗效,记录临床指标(呼吸机通气时间、感染控制时间及PICU住院时间),比较两组治疗前及治疗7 d时的血气指标,如动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、吸入氧浓度(FiO_(2))、动脉血氧饱和度(SaO_(2))的水平,记录两组不良反应(皮肤瘙痒、恶心呕吐、腹痛)发生情况。结果观察组治疗整体效果优于对照组,且治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组呼吸机通气时间、PICU住院时间及感染控制时间短于对照组(P<0.05);两组治疗7 d时PaO_(2)、SaO_(2)均较治疗前升高,PaCO_(2)、FiO_(2)均较治疗前降低,且观察组PaO_(2)、SaO_(2)高于对照组,PaCO_(2)、FiO_(2)低于对照组(P<0.05);两组治疗期间不良反应总发生率比较,差异未见统计学意义(P>0.05)。结论PICU重症肺炎患儿采用有创呼吸机联合抗生素阶梯疗法治疗效果确切,可有效改善患儿血气,促进患儿恢复,且安全性好。
Objective To observe the effect of invasive ventilator combined with antibiotic escalation therapy on children with severe pneumonia in pediatric intensive care unit(PICU).Methods Forty-three children with severe pneumonia in PICU who completed the treatment of invasive ventilator combined with antibiotic escalation therapy in Maternal and Child Health Hospital of Jiaozuo from January 2018 to June 2019 were selected and were included in the observation group.The of 40 children who completed the routine treatment of invasive ventilator combined with antibiotics during the same period were selected and included in the control group.The efficacy of the two groups after 7 days of treatment was evaluated,the clinical indicators such as ventilation time,infection control time and PICU hospital stay were recorded,the blood gas indexes such as arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),fraction of inspire O_(2)(FiO_(2)),arterial saturation of oxygen(SaO_(2))before and 7 days of treatment were compared between the two groups.The occurrence of adverse reactions such as skin itching,nausea and vomiting,abdominal pain of the two groups were recorded.Results The overall treatment effect of the observation group was better than that of the control group,and the total effective rate of treatment was higher than that of the control group,the differences were statistically significant(P<0.05);the ventilator ventilation time,PICU hospitalization time and infection control time of the observation group were shorter than those of the control group(P<0.05);at 7 days of treatment,PaO_(2) and SaO_(2) of the two groups were both higher than those before treatment,PaCO_(2) and FiO_(2) were both lower than those before treatment.PaO_(2) and SaO_(2) in the observation group were higher than those in the control group,and PaCO_(2) and FiO_(2) were lower than those in the control group(P<0.05);there was no diffterence in the total incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusions Children with severe pneumonia in PICU using invasive ventilator combined with antibiotic escalation therapy for treatment have definite effect,which can effectively improve the blood gas of the children and promote the recovery of the children,and has high safety.
作者
杨广平
秦新芳
张茂华
徐伟伟
Yang Guangping;Qin Xinfang;Zhang Maohua;Xu Weiwei(Department of PICU,Maternal and Child Health Hospital of Jiaozuo,Jiaozuo 454000,China)
出处
《中国实用医刊》
2021年第8期56-59,共4页
Chinese Journal of Practical Medicine
关键词
肺炎
重症
儿科重症监护病房
有创呼吸机
Pneumonia
Severe
Pediatric intensive care unit
Invasive ventilator
