林少珠 封业桥 陈赞钢 蓝秋梅

【摘要】 目的：觀察加温加湿高流量通气在重症肺炎中的应用价值研究。方法：选取2019年12月-2020年3月本院收治60例重症肺炎患儿，根据随机数字表法将患儿分成试验组和对照组，各30例。对照组进行常规高流量通气治疗，试验组进行加温加湿高流量通气治疗。比较两组临床症状消失时间，治疗前后炎性指标与血气指标水平，临床治疗效果与辅助机械通气率。结果：试验组心率、呼吸、发热、肺部啰音改善时间均短于对照组（P<0.05）。治疗后，两组的WBC、CRP水平均较治疗前降低，且试验组均低于对照组，差异均有统计学意义（P<0.05）。治疗后，两组PaCO2、PaO2、HCO3-及SaO2均较治疗前明显改善，且试验组均优于对照组，差异均有统计学意义（P<0.05）。试验组治疗总有效率为96.67%高于对照组的80.00%（P<0.05），辅助机械通气率低于对照组（P<0.05）。结论：在重症肺炎患儿的相关治疗中，辅助以加温加湿高流量通气治疗，可明显的缩短患儿临床症状消失时间，降低机体炎性指标水平，改善血气指标水平，提升临床治疗效果，降低辅助机械通气率。

【关键词】 加温加湿 高流量通气 重症肺炎

Study on the Application Value of Heating and Humidifying High Flow Ventilation in Severe Pneumonia/LIN Shaozhu， FENG Yeqiao， CHEN Zangang， LAN Qiumei. //Medical Innovation of China， 2021， 18（14）： -144

[Abstract] Objective： To observe the application value of heating and humidifying high flow ventilation in severe pneumonia. Method： A total of 60 children with severe pneumonia admitted to our hospital from December 2019 to March 2020 were selected. They were divided into experimental group and control group according to random number table method， 30 cases in each group. The control group was treated with routine high flow ventilation， the experimental group was treated with heating and humidification high flow ventilation. The time of disappearance of clinical symptoms， levels of inflammatory and blood gas indexes before and after treatment， clinical treatment effect and auxiliary mechanical ventilation rate were compared between the two groups. Result： The improvement time of heart rate， respiration， fever and pulmonary rales in experimental group were significantly shorter than those in control group （P<0.05）. After treatment， the levels of WBC and CRP in both groups were significantly decreased compared with before treatment， the levels of all indexes in the experimental group were lower than those in the control group， the differences were statistical significance （P<0.05）. After treatment， PaCO2， PaO2， HCO3- and SaO2 in both groups were significantly improved compared with before treatment， and the experimental group were better than those of the control group， with statistical significance （P<0.05）. The total effective rate of experimental group was 96.67%， higher than 80.00% of control group （P<0.05）， and the rate of auxiliary mechanical ventilation was lower than that of control group （P<0.05）. Conclusion： In the related treatment of children with severe pneumonia， auxiliary heating， humidification and high flow ventilation can significantly shorten the disappearance time of clinical symptoms in children， reduce the level of inflammatory indicators， improve the level of blood gas indicators， enhance the clinical treatment effect， and reduce the rate of auxiliary mechanical ventilation.

[Key words] Heating and humidification High flow ventilation Severe pneumonia

First-authors address： Yingde Maternal and Child Health and Family Planning Service Center， Yingde 513000， China

doi：10.3969/j.issn.1674-4985.2021.14.034

重症肺炎起病急来势猛为典型的临床表现及体征，常影响到全身，小儿重症肺炎是原发肺部感染所致的全身出现的严重状态，易致低氧血症、电解质紊乱等，可能诱发呼吸衰竭[1-3]。因此除了常规的治疗以外，需要辅助通气治疗。随着临床技术的不断进步，医疗不断地更新与探索，临床发现高流量吸氧对肺系疾病改善效果较佳[4]。而由于开通吸氧后尤其是小儿，常常开口呼吸，因此可能造成呼吸道干燥失去原有的清除异物的功能[5]。而目前的相关仪器中，存在可以针对通气治疗的气体进行加温加湿处理，以达到减少上述问题的目的。基于此，本研究选取重症肺炎患儿，采取加温加湿高通量通气治疗，旨在获得其临床干预效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2019年12月-2020年3月本院收治的60例小儿重症肺炎。（1）诊断标准：肺炎基础上出现一般情况差、拒食或脱水……