Effects of early continuous positive airway pressure on blood gas index and prognosis of children with severe pneumonia and respiratory failure
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摘要: 目的 探讨早期持续气道正压通气(CPAP)对小儿重症肺炎并发呼吸衰竭血气指标及预后的影响。 方法 选取本院接收诊治的68例重症肺炎并发呼吸衰竭患儿为研究对象,按照随机单双数法将所有患儿分为对照组和研究组,各34例。对照组患儿予以鼻导管吸氧等常规治疗,研究组患儿予以早期CPAP治疗。治疗1 d后,对比2组患儿治疗前后血氧饱和度(SaO2)、动脉血氧分压［p(O2)］、动脉血二氧化碳分压［p(CO2)］及氢离子浓度指数(pH值)等指标,并分析2组患儿预后情况。 结果 治疗后, 2组患儿SaO2、p(O2)、pH值水平均显著升高, p(CO2)水平显著降低; 研究组患儿SaO2、p(O2)、pH值水平均显著高于对照组, p(CO2)水平显著低于对照组(P<0.05)。2组患儿并发症发生率相比,差异无统计学意义(P>0.05); 研究组患儿死亡率为2.94%, 低于对照组的20.59%, 差异有统计学意义(P<0.05)。 结论 早期CPAP治疗重症肺炎并发呼吸衰竭患儿的效果显著,能够促进患儿血气指标的改善,同时能够有效减少其并发症及病死情况的发生,且能够促进患儿预后恢复。Abstract: Objective To investigate the effects of early continuous positive airway pressure(CPAP)on blood gas indexes and prognosis of children with severe pneumonia and respiratory failure. Methods A total of 68 children with severe pneumonia and respiratory failure admitted to our hospital were selected as research subjects. According to the random odd and even number method, all children were divided into control group and study group, with 34 cases per group. Children in the control group were treated with conventional treatments such as nasal catheter oxygen inhalation, and those in the study group were treated with early CPAP. After 1 day of treatment, the blood gas indexes such as oxygen saturation(SaO2), arterial partial pressure of oxygen［p(O2)］, partial arterial carbon dioxide pressure［p(CO2)］ and hydrogen ion concentration index(pH value)before and after treatment were compared between the two groups, and prognosis condition of the two groups was analyzed. Results After treatment, the levels of SaO2, p(O2)and pH value in the two groups were significantly increased, while the level of p(CO2)was significantly decreased, and the study group had significantly higher levels of SaO2, p(O2)and pH value, and lower p(CO2)than that 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 mortality rate in the study group was significantly lower than that in the control group, and the difference was statistically significant(2.94% vs. 20.59%, P<0.05). Conclusion Early CPAP is effective in treating severe pneumonia and respiratory failure in children, and it can promote improvement of blood gas index, effectively reduce incidence of complications and mortality, and promote - the prognostic recovery of children.
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