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目的探讨有创-无创序贯机械通气治疗重症肺炎伴呼吸衰竭患儿的临床疗效及安全性。方法选取2015年6月-2016年8月西安市儿童医院收治的重症肺炎伴呼吸衰竭患儿106例为研究对象,采用随机数字法将其分为对照组和观察组,每组各53例。对照组患儿接受持续性有创机械通气治疗,观察组患儿接受有创-无创序贯机械通气治疗,比较两组患儿治疗后的通气质量指标、血气分析指标及并发症发生率。结果治疗后,观察组患儿的p H值、动脉血氧分压(PaO_2)、氧合指数(PaO_2/FiO_2)、呼气时间(TE)、吸气时间(TI)、达到呼气峰流速时间(TPTEF)均明显高于对照组,动脉二氧化碳分压(Pa CO_2)、有创通气时间、总通气时间、ICU住院时间、并发症发生率和撤机成功率均明显低于对照组,差异均有统计学意义(均P<0.05)。两组患儿的死亡率比较,差异无统计学意义(P>0.05)。结论有创-无创序贯机械通气治疗重症肺炎伴呼吸衰竭患儿的临床效果显著,能明显提高患儿肺泡通换气质量,改善血气指标,且并发症发生率较低,患儿耐受性良好。
Objective To investigate the clinical efficacy and safety of invasive-noninvasive sequential mechanical ventilation in the treatment of children with severe pneumonia and respiratory failure. Methods From June 2015 to August 2016, 106 children with severe pneumonia and respiratory failure admitted to Xi’an Children’s Hospital were enrolled in this study. The patients were divided into control group and observation group with 53 cases in each group by random number method. Children in the control group received continuous invasive mechanical ventilation, and children in the observation group received invasive-invasive sequential mechanical ventilation. Ventilation quality, blood gas analysis and complication rates were compared between the two groups. Results After treatment, p H value, PaO 2, PaO 2 / FiO 2, expiration time (TI) and inspiration time (TI) in the observation group reached peak expiratory flow rate Time (TPTEF) were significantly higher than the control group. PaCO_2, invasive ventilation time, total ventilation time, ICU hospital stay, complications and weaning success rates were significantly lower than the control group, the difference All were statistically significant (P <0.05). There was no significant difference in mortality between the two groups (P> 0.05). Conclusions The invasive and noninvasive sequential mechanical ventilation has significant clinical effect in treating children with severe pneumonia and respiratory failure. It can significantly improve the quality of alveolar ventilation in children and improve the blood gas index, and the incidence of complications is low, and the tolerance of children good.