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目的探讨小潮气量机械通气对麻疹并发肺炎呼吸衰竭的临床疗效及肺保护效果。方法选取PICU隔离病房近几年收治的小儿重症麻疹并发肺炎呼吸衰竭需要机械通气治疗的46例患儿,采用小潮气量机械通气治疗,观察上机前后血气分析变化、呼吸机参数、机械通气并发症及预后等指标。结果本组病例治愈37例,治愈率82.6%,放弃治疗3例,死亡6例,死亡率13%;小潮气量肺保护通气VILI(呼吸机相关性肺损伤)的发生率明显低于大潮气量机械通气;上机后血气分析指标与上机前对比有明显改善。结论小潮气量机械通气适用于小儿重症麻疹并发肺炎呼吸衰竭者的治疗,有助于防止发生肺气肿、纵隔气肿或皮下气肿,提高小儿重症麻疹抢救成功率,降低死亡率。
Objective To investigate the clinical efficacy and protective effect of low tidal volume mechanical ventilation on measles complicated with pneumonia and respiratory failure. Methods 46 cases of pediatric severe measles complicated with pneumonia respiratory failure requiring mechanical ventilation were selected in PICU isolation ward in recent years. Small tidal volume mechanical ventilation was used to observe the changes of blood gas analysis, ventilator parameters, mechanical ventilation complications And prognosis and other indicators. Results In this group, 37 cases were cured, the cure rate was 82.6%, 3 cases were abandoned and 6 died, the mortality rate was 13%. The incidence of VILI (ventilator-associated lung injury) was significantly lower than that of the large tidal volume machine Ventilation; blood gas analysis indicators on the machine compared with the previous significantly improved. Conclusion Low tidal volume mechanical ventilation is suitable for the treatment of pediatric severe measles complicated with pneumonia and respiratory failure, which can help prevent emphysema, mediastinal emphysema or subcutaneous emphysema, improve the success rate of pediatric severe measles rescue and reduce mortality.