俯卧位通气治疗在高原重度小儿急性呼吸窘迫综合征中的应用效果

2021-12-13马燕春

婚育与健康 2021年21期

关键词：小儿

马燕春

【摘要】目的：探究高原重度小儿急性呼吸窘迫综合征实施俯卧位通气治疗的效果。方法：选取2020年4月至2021年4月我院收治的高原重度小儿急性呼吸窘迫综合征患儿82例，采取数字随机法分为试验组41例与对照组41例，对照组治疗以仰卧通气为主，试验组治疗以俯卧通气为主，对比两组氧合指数、腹腔压力、D-乳酸水平及不良事件发生率。结果：试验组患者氧合指数、腹腔压力、D-乳酸水平明显优于对照组，有统计学差异（P<0.05）；试验组与对照组不良事件发生率分别为4.88%、26.83%，试验组较对照组低，有统计学差异（P<0.05）。结论：高原重度小儿急性呼吸窘迫综合征患儿实施俯卧位通气治疗可改善患儿氧合指数，减少不良事件发生。

【关键词】急性呼吸窘迫综合征；小儿；重度；俯卧位通气治疗

Application effect of prone position ventilation therapy in severe infantile acute respiratory distress syndrome at high altitude

Ma Yanchun

Emergency Department， Womens and Childrens Hospital of Qinghai Province， Qinghai Xining 810007，China

【Abstract】Objective： To explore the effect of prone ventilation on severe acute respiratory distress syndrome in children at high altitude. Methods： 82 children with severe acute respiratory distress syndrome at high altitude treated in our hospital from April 2020 to April 2021 were randomly divided into 41 cases in the experimental group and 41 cases in the control group.The control group was mainly treated with supine ventilation and the experimental group was mainly treated with prone ventilation. The oxygenation index， abdominal pressure， D-lactate level and the incidence of adverse events were compared between the two groups.Results： the oxygenation index， abdominal pressure and D-lactic acidlevel in the experimental group were significantly better than those in the control group （P < 0.05）； The incidence of adverse events in the experimental group and the control group were 4.88% and 26.83% respectively. The incidence of adverse events in the experimental group was lower than that in the control group （P < 0.05）. Conclusion： prone position ventilation can improve oxygenation index and reduce adverse events in children with severe acute respiratory distress syndrome at high altitude.

【Key？Words】Acute respiratory distress syndrome； Children； Severe； Prone position ventilation therapy

臨床常见的一种小儿疾病为急性呼吸窘迫综合征，发病原因与肺部出现炎症有关，发病后肺重量及肺血管通透性提升，参加通气肺组织减少，临床以肺顺应性降低，低氧血症等症状为主要表现。有研究指出，急性呼吸窘迫综合征发病率约为10.4%，死亡率约40%。呼吸性支持治疗是临床治疗的主要方法，其目的是改善肺复张，但经临床实践证实，氧合改善效果较差，增加治疗难度。俯卧位通气治疗满足肺生理病理机制，增加患儿生存时间，减少不良事件发生。本研究选取我院收治的高原重度小儿急性呼吸窘迫综合征患儿82例，41例采取仰卧位通气治疗，另外41例采取俯卧位通气治疗，分析治疗效果，现报道如下。