论文部分内容阅读
目的 探讨无创正压通气治疗重症手足口病的疗效.方法 选择2011年1~12月入江西省儿童医院急诊中心和手足口病病房的重症患者(2期、3期)65例,分为对照组35例,按常规方法治疗(米力农、丙种球蛋白等),观察组30例,观察组在常规治疗基础上加经鼻持续气道正压.结果 65例重症手足口病中男46例(70.77%),女19例(29.23%),年龄4个月~5岁,平均年龄1岁11个月,其中2期患儿23例(35.38%),3期42例(64.61%),肠道病毒71型阳性62例(95.38%).观察组与对照组患儿的性别、年龄、病情分期及病原学结果的比较差异均无统计学意义(P>0.05).治疗2 h后观察组的PaO2(83.6 ± 19.4 mmHg)较对照组(71.7±17.5 mmHg)改善明显,两者比较差异有统计学意义(P<0.05);观察组血压(90.3± 10.7)/(52.5±6.8)mmHg较对照组(108.2±9.9)/(64.3±5.5)低,二者比较差异有统计学意义(P<0.05);且观察组住院时间(9.2±2.1 )d ,短于对照组(13.2±4.6)d,两者比较差异有统计学意义(P<0.05).观察组3期0例进入4期,对照组有8例进入4期,两者比较差异有统计学意义(P<0.05);观察组和对照组有创机械通气使用率分别为0%和20%,两者比较差异有统计学意义(P0.05) in the gender, age, disease stage, pathogen, WBC and blood sugar between the two groups. The PaO2 , SaO2 in observation group (83.6 ± 19.4mmHg, 94.5 ± 15.4%) were higher than that control groups (71.7 ± 17.5mmHg, 89.3 ± 17.6%) after 2 hours of treatment, and heart rate, blood pressure of the observation group was lower than that of the control group, which showed a significant difference (P<0.05). The hospitalization duration in control group (13.2±4.6 days) was longer than that of observation group (9.2±2.1days), which was significant (P<0.05). No patients on stage 3 of the observation group developed to stage 4, and 8 patients on stage 3 of the control group developed to stage 4 (P<0.05). The utilization rate (20%) of invasive mechanical ventilation in the control group was higher than that of the observation groups (0%) (P<0.05). Conclusions NCPAP combined with the conventional treatment for severe HFMD is considered asan effective measure in improving hypoxemia and circulatory function, shortening hospital stays, reducing invasive mechanical ventilation.