俯卧位机械通气辅助药物治疗小儿重症肺炎临床效果分析
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摘要
目的探讨小儿重症肺炎中俯卧位机械通气辅助药物治疗的临床效果。方法选择2014年4月—2018年9月期间开展研究,88例研究对象均为方便选取该院接诊治疗的小儿重症肺炎患儿,遵循计算机表法对所有研究对象进行44例每组的分组处理,两组患儿均实施俯卧位机械通气辅助药物措施,对照组落实常规药物治疗,观察组落实小剂量多巴胺、多巴酚丁胺治疗,评价两组治疗有效情况、症状消失时间。结果观察组症状消失时间呼吸抑制(2.55±1.03)d、发热(3.04±1.06)d、肺部啰音(4.62±1.02)d、咳嗽(3.12±1.33)d均少于对照组(4.48±1.16)、(5.01±1.43)、(6.37±1.25)、(5.48±1.37)d,组间差异有统计学意义(t=8.252 6、7.341 2、7.195 1、8.198 6,P=0.000 0、0.000 0、0.000 0、0.000 0)。对照组总有效率77.27%,观察组总有效率97.73%,两组比较观察组总有效率为组间最高,检验结果差异有统计学意义(χ~2=8.415 6,P=0.003 7)。结论在应用俯卧位机械通气辅助小儿重症肺炎的治疗时,选择联合小剂量多巴胺、多巴酚丁胺治疗,可以提升患儿临床治疗效果,促进患儿康复。
Objective To observe the clinical effect of mechanical ventilation in the prone position in children with severe pneumonia. Methods The study was convenient selection conducted from April 2014 to September 2018. All the 88 subjects were children with severe pneumonia admitted to our hospital. All subjects were grouped into 44 cases/group according to the computerized method. The two groups of children were treated with prophylactic mechanical ventilation and auxiliary drugs. The control group was treated with conventional drugs. The observation group was treated with low-dose dopamine and dobutamine treatment. The effective treatment and disappearance time of the two groups were evaluated. Results Respiratory depression(2.55±1.03) d, fever(3.04±1.06) d, pulmonary voice(4.62±1.02) d, cough(3.12±1.33) d were lower in the observation group than in the control group(4.48±1.16)d,(5.01±1.43)d,(6.37±1.25)d,(5.48±1.37)d, the statistical difference was significant(t=8.252 6, 7.341 2, 7.195 1, 8.198 6, P=0.000 0, 0.000 0, 0.000 0, 0.000 0). The total effective rate of the control group was 77.27%, and the total effective rate of the observation group was 97.73%. The total effective rate of the two groups was the highest between the groups, and the test results were statistically different(χ~2=8.415 6, P=0.003 7).Conclusion In the treatment of severe pneumonia in children with prone position ventilation, the combination of low-dose dopamine and dobutamine can improve the clinical treatment of children and promote the recovery of children.
Objective To observe the clinical effect of mechanical ventilation in the prone position in children with severe pneumonia. Methods The study was convenient selection conducted from April 2014 to September 2018. All the 88 subjects were children with severe pneumonia admitted to our hospital. All subjects were grouped into 44 cases/group according to the computerized method. The two groups of children were treated with prophylactic mechanical ventilation and auxiliary drugs. The control group was treated with conventional drugs. The observation group was treated with low-dose dopamine and dobutamine treatment. The effective treatment and disappearance time of the two groups were evaluated. Results Respiratory depression(2.55±1.03) d, fever(3.04±1.06) d, pulmonary voice(4.62±1.02) d, cough(3.12±1.33) d were lower in the observation group than in the control group(4.48±1.16)d,(5.01±1.43)d,(6.37±1.25)d,(5.48±1.37)d, the statistical difference was significant(t=8.252 6, 7.341 2, 7.195 1, 8.198 6, P=0.000 0, 0.000 0, 0.000 0, 0.000 0). The total effective rate of the control group was 77.27%, and the total effective rate of the observation group was 97.73%. The total effective rate of the two groups was the highest between the groups, and the test results were statistically different(χ~2=8.415 6, P=0.003 7).Conclusion In the treatment of severe pneumonia in children with prone position ventilation, the combination of low-dose dopamine and dobutamine can improve the clinical treatment of children and promote the recovery of children.
引文
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[7]杜玉明,李岩,孙荣青,等.俯卧位通气对重症肺炎患者氧合影响的Meta分析[J].中华危重病急救医学,2018,30(4)327.
[8]范徐威.俯卧位机械通气辅助药物治疗小儿重症肺炎临床观察[J].现代诊断与治疗,2017,28(01):49-51.
[9]Du Yuming,Li Yan,Sun Rongqing,et al.Meta-analysis of the effect of prone position ventilation on oxygenation in patients with severe pneumonia[J].Zhongguo Critical Care Medicine,2018,30(4):327.
[10]Lai Min,Wu Guihui,Chen Hongde,et al.Risk factors for death in patients with pulmonary tuberculosis complicated with severe pneumonia undergoing invasive mechanical ventilation[J].Journal of Clinical Pulmonary Medicine2018,23(1):115-118.
[11]Lai Min,Wu Guihui,Chen Hongde,et al.Risk factors for death in patients with pulmonary tuberculosis complicated with severe pneumonia undergoing invasive mechanical ventilation[J].Journal of Clinical Pulmonary Medicine,201823(1):115-118.
[12]Wang Bizhen.Retrospective analysis of the efficacy of diff erent mechanical ventilation methods in the treatment of severe pneumonia[J].Fujian Journal of Medicine,2017,39(5):180-181.
[2]赖敏,吴桂辉,陈洪德,等.肺结核合并重症肺炎行有创机械通气患者的死亡危险因素分析[J].临床肺科杂志,201823(1):115-118.
[3]张婷.机械振动排痰在婴幼儿重症肺炎机械通气气道护理中的应用效果[J].中国医药指南,2017,15(15):217-218.
[4]周旋,石霖,林志雄,等.面罩持续气道正压机械通气治疗小儿重症肺炎疗效分析[J].海南医学院学报,2018,206(7)40-41,45.
[5]杨琳东,王秀萍,王娟.小潮气量机械通气治疗对小儿重症肺炎血气学指标的影响[J].海南医学,2017,28(16):2639-2641.
[6]李雅昆.两种卧位在机械通气治疗重症肺炎中的效果[J].包头医学院学报,2018,34(4):80-81.
[7]杜玉明,李岩,孙荣青,等.俯卧位通气对重症肺炎患者氧合影响的Meta分析[J].中华危重病急救医学,2018,30(4)327.
[8]范徐威.俯卧位机械通气辅助药物治疗小儿重症肺炎临床观察[J].现代诊断与治疗,2017,28(01):49-51.
[9]Du Yuming,Li Yan,Sun Rongqing,et al.Meta-analysis of the effect of prone position ventilation on oxygenation in patients with severe pneumonia[J].Zhongguo Critical Care Medicine,2018,30(4):327.
[10]Lai Min,Wu Guihui,Chen Hongde,et al.Risk factors for death in patients with pulmonary tuberculosis complicated with severe pneumonia undergoing invasive mechanical ventilation[J].Journal of Clinical Pulmonary Medicine2018,23(1):115-118.
[11]Lai Min,Wu Guihui,Chen Hongde,et al.Risk factors for death in patients with pulmonary tuberculosis complicated with severe pneumonia undergoing invasive mechanical ventilation[J].Journal of Clinical Pulmonary Medicine,201823(1):115-118.
[12]Wang Bizhen.Retrospective analysis of the efficacy of diff erent mechanical ventilation methods in the treatment of severe pneumonia[J].Fujian Journal of Medicine,2017,39(5):180-181.