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BIPAP通气模式对重症手足口病合并神经源性肺水肿患儿呼吸功能的影响
作者:宋庆梅 张晓 温玲玲 
单位:(河南省南阳市第一人民医院儿三科 南阳473000) 
关键词:重症手足口病 神经源性肺水肿 BIPAP通气模式 呼吸功能 
分类号:R725
出版年,卷(期):页码:2019,47(6):448-451
摘要:

目的 探讨双水平气道正压(BIPAP)通气模式对重症手足口病合并神经源性肺水肿患儿呼吸功能的影响。方法 选取2017年3月至2018年8月收治的86例重症手足口病合并神经源性肺水肿患儿,根据随机数字表分为对照组和观察组各43例。两组均采用同步间歇指令通气(SIMV)+呼气末正压(PEEP)治疗,治疗30 min后,对照组治疗模式不变,观察组更改为BIPAP通气模式,对比两组呼吸功能、动脉血气分析指标及机械通气时间。结果 治疗后,两组Pplat、气道峰压、肺顺应性、PaCO2及PaO2/FiO2均改善(P<0.05),且观察组Pplat、气道峰压及PaCO2水平较对照组低,肺顺应性及PaO2/FiO2水平较对照组高(P<0.01);观察组机械通气时间较对照组短(P<0.01)。结论 重症手足口病合并神经源性肺水肿患儿采取BIPAP通气模式治疗可有效改善呼吸功能及氧合,缩短患儿机械通气时间。

Objective To investigate the effect of bi-level positive airway pressure(BIPAP) ventilation mode on respiratory function of children with severe hand-foot-mouth disease(HFMD) complicated with neurogenic pulmonary edema.Methods 86 children with severe HFMD complicated with neurogenic pulmonary edema admitted to hospital from March 2017 to August 2018 were selected.They were divided into control group and observation group according to random number table,with 43 cases in each group.Both groups were treated with simultaneous intermittent mandatory ventilation(SIMV) and positive end-expiratory pressure(PEEP).After 30 minutes of treatment,the treatment mode of the control group remained unchanged,while that of the observation group changed to BIPAP ventilation mode.And then,respiratory function,arterial blood gas analysis index and mechanical ventilation time were compared between the two groups.Results After treatment,Pplat,peak airway pressure,lung compliance,PaCO2 and PaO2/FiO2 all improved in both groups(P<0.05),and the levels of Pplat,peak airway pressure and PaCO2 in the observation group were lower than those in the control group,while the levels of pulmonary compliance and PaO2/FiO2 in the observation group were higher than those in the control group(P<0.01),and the mechanical ventilation time in the observation group was shorter than that in the control group(P<0.01).Conclusion BIPAP ventilation can effectively improve respiratory function and oxygenation,and shorten the duration of mechanical ventilation in children with severe hand-foot-mouth disease complicated with neurogenic pulmonary edema.

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