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目的探讨不同湿化氧疗对先天性心脏病术后婴幼儿下呼吸道感染的影响,为临床制定预防控制措施提供依据。方法选取2012年6月-2015年5月医院收治的3月~3岁的先天性心脏病术后停用呼吸机拔除气管插管需要氧疗患儿100例,分为两组,观察组采用新西兰MR810呼吸机加温湿化器将湿化液加温,氧气吸入管口气体温度为32~36℃,对照组采用常温湿化液,氧气吸入管口气体温度为20~26℃;各组分别于吸氧前、吸氧48h后观察临床肺部感染评分(CPIS);统计两组吸氧前与吸氧48h后下呼吸道感染率和病原菌检出情况。结果两组在吸氧前CPIS差异无统计学意义,吸氧48h后观察组CPIS下降更为显著,差异有统计学意义(P<0.05);同组间比较,对照组吸氧前后CPIS差异无统计学意义,观察组吸氧前后CPIS差异有统计学意义(P<0.05);吸氧48h后观察组下呼吸道感染率下降更为显著;共分离出22株病原菌,以革兰阴性菌为主。结论加温湿化氧疗能降低先天性心脏病婴幼儿心脏手术后肺部感染评分,能有效地减少呼吸道感染并发症的发生。
Objective To investigate the effect of different humidified oxygen therapy on lower respiratory tract infection in infants and young children with congenital heart disease and to provide basis for clinical prevention and control measures. Methods From June 2012 to May 2015, 100 patients with congenital heart disease who were admitted to our hospital from March to March of age undergoing cardiopulmonary bypass were enrolled and divided into two groups. The observation group was divided into two groups New Zealand MR810 ventilator warmer humidifier humidified liquid, oxygen inlet temperature of 32 ~ 36 ℃, the control group was humidified liquid at room temperature, oxygen inhalation nozzle gas temperature is 20 ~ 26 ℃; each group The clinical pulmonary infection score (CPIS) was observed 48 hours after oxygen inhalation and before oxygen inhalation respectively. The infection rate of lower respiratory tract and the detection of pathogenic bacteria in the two groups were recorded before oxygen inhalation and 48 hours after oxygen inhalation. Results There was no significant difference in CPIS between the two groups before oxygen inhalation. After 48 hours of oxygen inhalation, the CPIS decreased more significantly in the observation group (P <0.05). Compared with the control group, CPIS difference before and after oxygen inhalation Statistical significance, CPIS before and after the observation group was statistically significant difference (P <0.05); oxygen inhalation 48h after the observation group decreased more significantly lower respiratory tract infection; isolated a total of 22 strains of pathogens, mainly gram-negative bacteria . Conclusions Warming and humidifying oxygen therapy can reduce the score of pulmonary infection in infants with congenital heart disease after cardiac surgery, which can effectively reduce the complication of respiratory tract infection.