疑难病杂志2017 年11 月第 16 卷第 11 期Chin J Diffic and Compl C a s，N〇v e m b e r2017，V〇1.16 No.ll? 1123 ?
论著?临床
道正压通气治疗 地
症肺炎患儿效果及对血 的影响
邓英，唐霞，张雪琼，刘勤
作者单位：626000康定，四川省甘孜藏族自治州人民医院儿科
通信作者：邓英，E-mail :501205413@qq. cm
【摘要】目的观察鼻塞式持续气道正压通气（CPAP)治疗高原地区重症肺炎患儿临床效果及对血气指标的
影响。方法将2014年2月一2017年2月甘孜藏族自治医院儿科收治的92例小儿重症肺炎作为研究对象，
随机数字表法分为观察组和对46例。2组患儿人院后给予综合性基础治疗，对给予面罩吸氧，观察组给
予鼻塞式持续气道正压通气。2组患者均治疗24 h。比较2组患儿治疗前、治疗24 h后血气（Pa〇2、PaC〇2、Sa〇2)变
化情况，评价临床效果，追踪患儿临床症状缓解时间及不良反应。结果观察组总有效率为93.5%，显著高于对照组
的=0.036);观察组患儿Pa02、Sa02明显高于对照组，PaC02显著低于对照组（〖=8.242、
10.299、5.507, /^均=0.000);观察组呼吸困难缓解时间、发绀消失时间、心率恢复正常时间、肺啰音消失时间、胸骨凹
陷消失时间及住院时间明显短于对照组（〖=7.723、7.897、5.477、6.226、5.495、4.963, ^均=0.000);组患儿在治
疗过程中鼻黏膜轻微充血、瘙痒、擦伤等不良反应发生率比较，差异无统计学意义（X2=1.93、0.956、0.209, P =
0.206、0.328、0.647)。结论鼻塞式持续气道正压通气治疗高原地区重症肺炎患儿临床效果确切，能改善患儿血气
指标，减轻炎性反应状态，安全性好，值得临床推广应用。
【关键词】重症肺炎;高原地区；道正压通气，鼻塞式;血气分析;小儿
【D0I】10.3969 / j. issn. 1671-450.2017.11.012
Mfect of nasal t ampon style continuous airway positive pressure ventilation on children witli severe pneumonia in
plateau area and its effect on blood gas index D ENG Ying，TANG Xia，ZHANG Xueqiong，LIU Qin. Department of tries, Garni Tibetan Autonomous Prefecture People s Hospital, K angding 626000，China
Corresponding author：DENG Ying，E-mail：501205413@c o m
【A bstract】Objective To investigate the effect of nasal tampon style continuous airway positive pressure ventilation
on children with severe pneumonia in plateau area and its effect on blood gas index. Methods Ninety-two cases of children
with severe pneumonia in plateau area were selected, which were treated in department of pediatrics mous Prefecture People s Hospital f rom February 2014 to February 2017，and they were divided into the observation group (46
cases) and control group (46 cases). The patients of two groups were all treated with comprehensive basic treatment after ad-mission. The patients of control group were treated with mask o xygen，while the patients of observation group were tre nasal tampon style continuous airway positive pressure ventilation. The patients of two groups were all treated fo row. Compare the clinical symptoms remission time，clinical effect，safety and changes of the Pa two groups before and after treatment for 24 hours. Results The patients of the observation group got a total effective rate of
93.5%，which was significantly better than the 78. 3% of the control group (X= 4. 389; P = 0. 036) ; The Pa02，Sa02
levels of the observation group were significantly higher than those of the control group, and the PaC02 levels of the observation
group were significantly lower than those of the control group (=8. 242，= 10. 299，= 5. 507 ; P = 0. 000，P = 0. 000，P =
0. 000) ；The d yspnea time, cyanosis disappearance time, heart rate returned to normal time, lung rales disappear time，ster-
nal sag disappearance time a nd length of stay of the observation group were significantly lower than those of the control group
(t = 7.723，t = 7.897，t = 5.477，t = 6.226，t = 5.495，t = 4.963; P=0.000，P= 0.000，P= 0.000，P= 0.000，P =
0. 000，P = 0. 000) ; There were nasal mucosa slightly congested，itching，wiping pain and other adverse reactions occurred in
both two groups，but there were no statistically significant between the two groups ( X= 1.593，0. 956，0. .09，P >0. 05 ).