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常规联合呼吸机辅助治疗小儿重症毛细支气管炎的疗效及其安全性
边朋,何兴宇,杨丽炜,马建利,黄东华
0
(冀中能源峰峰集团总医院新生儿科)
摘要:
目的 探讨常规联合呼吸机辅助治疗小儿重症毛细支气管炎的疗效及其安全性。方法 选择2015年6月~2017年6月于我院治疗的110例小儿重症毛细支气管炎患者,按数字随机法分为对照组与观察组,每组55例,对照组采用常规止咳平喘、抗感染、雾化吸痰及糖皮质激素治疗,观察组在此基础上加用呼吸机辅助治疗。治疗前后进行血气分析,比较两组患儿各项症状、体征消退时间、血清炎性因子水平,评价临床疗效,并观察并发症发生情况。结果 观察组治疗总有效率为9273%,显著高于对照组的8182%,组间差异有统计学意义(P<0.05);两组治疗前后动脉血氧分压(PaO2)、血二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)差异均有统计学意义(P<0.05);治疗后6h及1、2d时观察组与对照组间差异亦有统计学意义(P<0.05),而血液PH值差异无统计学意义(P>0.05);观察组呼吸、心率恢复正常时间,肺部啰音、喘憋、咳嗽消失时间均显著低于对照组,差异有统计学意义(P<0.05);两组并发症发生情况差异无统计学意义(P>0.05);两组治疗后血清炎性因子水平均显著降低,且治疗后观察组血清TNFα、IL-4、IL-8水平均显著低于对照组,差异均有统计学意义(P<0.05)。结论 小儿重症毛细支气管炎采用常规治疗联合呼吸机辅助治疗能显著改善高碳酸血症,缩短咳嗽、喘憋等呼吸症状体征,降低炎症反应,提升临床疗效,治疗安全有效。
关键词:  呼吸机辅助治疗  小儿重症毛细支气管炎  疗效  安全性
DOI:
基金项目:河北省科技厅科技攻关项目(20140529)
The efficacy and safety of conventional therapy combined with ventilator assisted therapy for children with severe bronchiolitis
BIAN Peng,HE Xingyu,YANG Liwei,MA Jianli,HUANG Donghua
(Department of Newborn Pediatrics, Jizhong Energy Fengfeng General Hospital)
Abstract:
Objective To investigate the efficacy and safety of conventional therapy combined with ventilator assisted therapy for children with severe bronchiolitis. Methods 110 children with severe bronchiolitis treated in our hospital from June 2015 to June 2017 were selected and randomly divided into control group and observation group, respectively. The control group was treated with relieving cough and asthma, routine anti-infection, atomization suction, and glucocorticoid symptomatic treatment. On this basis, the observation group was treated with ventilator assisted therapy. Blood gas analysis was carried out before and after treatment, and the symptoms and signs subsided time, and the serum inflammatory factor levels were compared. The clinical efficacy were evaluated, and the incidence of complications were compared. Results The total effective rate of the observation group was 92.73%, which was significantly higher than that of the control group (81.82%), the difference was statistically significant (P<0.05). Before and after treatment, PaO2, PaCO2 and PaO2 / FiO2 were significantly different between the two groups (P<0.05); And the difference between the observation group and the control group at 6h, 1d and 2d after treatment was statistically significant (P<0.05), while the blood PH value was no significant difference (P>0.05). The recovery time of breathing and heart rate, and the disappearing time of the lung rales, wheezing and cough in the observation group were significantly shorter than those in the control group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05); The serum inflammatory factor levels were decreased after treatment, and the serum TNFα, IL-4 and IL8 levels were lower in the observation group than in the control group (P<0.05). Conclusion The conventional therapy combined with ventilator assisted therapy is an effective and safe way to ameliorate hypercapnia and the respiratory symptoms such as cough and wheezing for children with severe bronchiolitis.
Key words:  Ventilator assisted therapy  Severe bronchiolitis in children  Efficacy  Safety

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