余杨贵州省安顺市妇幼保健院儿科，贵州安顺　561000

鼻塞式持续气道正压通气治疗婴儿重症肺炎的临床研究

余杨
贵州省安顺市妇幼保健院儿科，贵州安顺561000

目的通过对鼻塞式持续气道正压通气（n-CPAP）治疗婴儿重症肺炎的临床分析，研究其临床疗效、安全性及n-CPAP并发症的防范。 方法分析本院儿科2014年1月～2016年3月收治的113例婴儿重症肺炎病例，把使用鼻塞持续气道正压通气的57例纳入观察组，使用头罩给氧方式的56例纳入对照组，两组病例均给予抗感染、雾化等综合治疗。分析比较两组患儿入院时与入院后24 h血气分析PCO2、PO2的变化，呼吸困难缓解时间、心率恢复正常时间、发绀及肺部体征（肺部啰音）消失时间，疗效及平均住院天数等指标，同时观察n-CPAP并发症发生情况。 结果观察组入院后24 h血气分析PO2较对照组明显改善，临床症状改善及肺部体征消失时间、平均住院天数较对照组缩短，观察组疗效优于对照组，差异有统计学意义（P＜0.05）。观察组未出现鼻塞式持续气道正压通气相关的严重并发症。结论 鼻塞式持续气道正压通气治疗婴儿重症肺炎安全、疗效满意，操作简便，适宜临床推广应用。

鼻塞式持续气道正压通气；婴儿；重症肺炎；疗效；并发症

［Abstract］Objective To investigate the c1inica1 effects，safety，and prevention of n-CPAP comp1ications by c1inica1 ana1ysis on nasa1 continuous positive airway pressure（n-CPAP）in treatment of severe pneumonia of infants.Methods 113 infants with severe pneumonia treated in our department from January 2014 to March 2016 were ana1yzed.The 57 patients receiving n-CPAP were enro11ed in the observation group，and the 56 patients receiving head-mask oxygen inha1ation were enro11ed in the contro1 group.Patients in both groups were given treatments inc1uding anti-infection and atomization.The changes of PCO2and PO2of b1ood gas ana1ysis at admission and at 24 h after admission，remission time of dyspnea，norma1ization time of heart rate，remission time of cyanosis and pu1monary signs（ra1e in 1ungs），efficacy and average hospita1 stay were ana1yzed.Incidence of n-CPAP comp1ications was observed.Results The PO2of b1ood gas ana1ysis at 24 h after admission was significant1y improved in the observation group than in the contro1 group，and the remission time of c1inica1 symptoms and pu1monary signs and the average hospita1 stay were significant1y shorter in the observation group than in the contro1 group（P＜0.05）.There was significant difference in efficacy between two groups.No severe n-CAPA re1ated comp1ication was observed in the observation group.Conclusion App1ication of n-CPAP has favorab1e safety and efficacy in treatment of severe pneumonia of infants，which is a1so convenient to operation and is worthy to be promoted.

［Key words］Nasa1 continuous positive airway pressure；Infant；Severe pneumonia；Efficacy；Comp1ication

肺炎为小儿时期重要的常见病，是我国住院小儿死亡的第一位原因，也是5岁以下儿童的第一位死亡原因，严重威胁小儿身体健康，被卫生部列为小儿四病防治之一。特别是1岁以内的婴儿重症肺炎，由于自身呼吸系统发育不成熟，自身免疫力低下，具有发病快、进展快、变化快、并发症多等特点，常出现病情恶化导致生命危险。……