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目的探讨机械通气在治疗重症手足口病合并神经源性肺水肿患儿中的临床价值。方法对南阳市中心医院PICU2010年4—7月收治的82例手足口病合并神经源性肺水肿患儿均给予气管插管机械通气治疗,均采用经口插管,采用压力控制模式,并加用呼气末正压通气(PEEP),同时给予药物治疗。结果 82例中抢救成功81例,1例为放弃治疗,机械通气时间3~21d,住院时间7~26d,平均12.8d,除1例放弃治疗,5例因迟缓性瘫痪转康复科治疗外,均治愈出院。结论在药物治疗基础上,及时给予机械通气治疗重症手足口病合并神经源性肺水肿,能迅速改善低氧血症,减轻肺部渗出,为提高抢救成功率的关键手段。
Objective To investigate the clinical value of mechanical ventilation in the treatment of severe hand-foot-mouth disease in children with neurogenic pulmonary edema. Methods 82 cases of hand, foot and mouth disease complicated with neurogenic pulmonary edema admitted to PICU of Nanyang Central Hospital from April to July in 2010 were given mechanical ventilation of tracheal intubation. All patients were treated with oral intubation and pressure control mode Positive end expiratory pressure (PEEP), while giving medication. Results Eighty-one patients were successfully rescued in 81 cases. One patient gave up treatment, the duration of mechanical ventilation was 3 to 21 days, the duration of hospitalization was 7 to 26 days (average 12.8 days). One patient gave up treatment and 5 patients were delayed to paralysis and transferred to rehabilitation department. All were cured. Conclusions On the basis of drug treatment, timely mechanical ventilation for severe hand-foot-mouth disease complicated with neurogenic pulmonary edema, can quickly improve hypoxemia, reduce pulmonary exudation, to improve the success rate of rescue key means.