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目的观察应用不同潮气量机械通气治疗小儿重症肺炎的疗效差别。方法选择2009年1月至2010年6月收住吉林大学第一医院儿童重症监护室(PICU)进行机械通气治疗的小儿重症肺炎50例,根据潮气量的不同分为两组:小潮气量组(潮气量6～8mL/kg)25例,传统潮气量组(潮气量10～12mL/kg)25例,进行数据整理,观察机械通气后血气分析、呼吸机参数变化,观察其机械通气时间、病死率,对存活患儿随访呼吸系统症状。结果机械通气24h后传统潮气量组PaO2及氧合指数比值(P/F)较小潮气量组高,PaCO2、pH较小潮气量组低;机械通气时间传统潮气量组为(5.4±1.8)d,小潮气量组为(9.5±1.7)d;病死率传统潮气量组为16.0%,小潮气量组为32.0%。存活患儿反复呼吸道感染发生率传统潮气量为28.6%,小潮气量组为31.3%。结论传统潮气量机械通气治疗小儿重症肺炎的疗效优于小潮气量机械通气。
Objective To observe the curative effect of applying different tidal volume mechanical ventilation to treat pediatric severe pneumonia. Methods Fifty children with severe pneumonia admitted to the Children’s Intensive Care Unit (PICU) of the First Hospital of Jilin University from January 2009 to June 2010 were divided into two groups according to the tidal volume: small tidal volume group Tidal volume 6 ~ 8mL / kg) 25 cases, the traditional tidal volume (tidal volume 10 ~ 12mL / kg) in 25 cases, data were collected, mechanical ventilation was observed after blood gas analysis, changes in ventilator parameters observed mechanical ventilation time, died Rate, follow-up of respiratory symptoms of surviving children. Results The values of PaO2 and oxygenation index (P / F) in the traditional tidal volume group after mechanical ventilation were lower than those with lower tidal volume and lower PaCO2 and pH tidal volume. The traditional tidal volume of mechanical ventilation time was (5.4 ± 1.8) d, the small tidal volume was (9.5 ± 1.7) d; the mortality was 16.0% in the traditional tidal volume group and 32.0% in the small tidal volume group. The incidence of recurrent respiratory tract infections in children with the traditional tidal volume was 28.6%, small tidal volume was 31.3%. Conclusion The effect of traditional tidal volume mechanical ventilation on infantile severe pneumonia is better than that of low tidal volume mechanical ventilation.