论文部分内容阅读
目的探讨小潮气量通气治疗儿童呼吸道合胞病毒并发肺炎呼吸衰竭的临床疗效及肺保护作用。方法选取儿童重症监护室2002年1月至2010年2月收治的小儿呼吸道合胞病毒并发肺炎呼吸衰竭需要机械通气治疗患儿。2002年1月至2005年1月采用大潮气量通气策略,共53例患儿(大潮气量组);2005年2月至2010年2月采用小潮气量通气策略,共76例患儿(小潮气量组)。观察两组之间呼吸机参数、机械通气并发症及预后等指标。比较小潮气量组机械通气前、通气后6～8 h和通气后24 h的血气分析。结果小潮气量通气组的气漏发生率显著低于大潮气量通气组;小潮气量机械通气能明显改善低氧血症和二氧化碳潴留,同时避免过度通气。结论呼吸道合胞病毒并发肺炎呼吸衰竭患儿机械通气策略适宜于小潮气量,它能够降低气压伤发生。
Objective To investigate the clinical efficacy and protective effect of small tidal volume ventilation on children with respiratory syncytial virus complicated with pneumonia and respiratory failure. Methods Children’s intensive care unit from January 2002 to February 2010 admitted to children with respiratory syncytial virus pneumonia respiratory failure require mechanical ventilation in children. A total of 53 children (large tidal volume) were recruited from January 2002 to January 2005 with a strategy of large tidal volume ventilation. From February 2005 to February 2010, a total of 76 children (small tidal volume ). Ventilator parameters, mechanical ventilation complications and prognosis were observed between the two groups. Comparison of small tidal volume before mechanical ventilation, ventilation after 6 ~ 8 h and 24 h after ventilation blood gas analysis. Results The incidence of air leaks in the small tidal volume ventilation group was significantly lower than that in the large tidal volume ventilation group; low tidal volume mechanical ventilation could significantly improve hypoxemia and carbon dioxide retention while avoiding hyperventilation. Conclusions The mechanical ventilation strategy of respiratory syncytial virus in children with pneumonia and respiratory failure is suitable for small tidal volume, which can reduce the incidence of barotrauma.