经鼻导管高流量吸氧与经鼻气道正压通气在重症毛细支气管炎呼吸支持中的应用价值比较

目的:比较经鼻导管高流量吸氧(HFNC)与经鼻气道正压通气(nCPAP)在重症毛细支气管炎呼吸支持中的应用价值,为临床治疗方案的选择提供参考。方法:选取2016年12月至2018年12月我院儿科收治的重症毛细支气管炎患儿90例,采用随机数表法分为观察组和对照组各45例。两组患儿入院后均给予常规综合治疗以保证呼吸道通畅,在此基础上观察组采用HFNC治疗,对照组采用nCPAP治疗,比较两组患儿治疗前和治疗24 h后呼吸频率、经皮血氧饱和度(TcSO2)、呼吸窘迫评分体系(CSS)评分、动脉血氧分压(PaO2)等呼吸相关指标及治疗前后临床症状体征改善情况。结果:两组患儿治疗24 h后呼吸频率、CSS评分均降低,且观察组降低程度更大,TcSO2、PaO2于治疗24 h后升高,观察组升高幅度较对照组明显;治疗后两组患儿咳嗽及肺部湿啰音、肺部炎症情况均改善,观察组症状体征消失时间早于对照组,差异均有统计学意义(P<0. 05)。结论:重症毛细支气管炎患儿采用HFNC治疗可明显改善通气功能和临床症状,治疗效果优于nCPAP治疗,可扩大样本量进一步观察。

Comparison of Application Value of High Flow Nasal Cannula and Nasal Continuous Positive Airway Pressure in Respiratory Support for Severe Bronchiolitis

Objective: To compare the application value of high flow nasal cannula (HFNC) and nasal continuous positive airway pressure (nCPAP) in respiratory support for severe bronchiolitis, so as to provide reference for the selection of clinical treatment regimen. Methods: A total of 90 children with severe bronchiolitis admitted into the pediatrics of our hospital from Dec. 2016 to Dec. 2018 were enrolled to be divided into the observation group and the control group via the random number table, with 45 cases in each group. After admission, two groups were given conventional comprehensive treatment to ensure the smoothness of respiratory tract. On this basis, the observation group was treated with HFNC, and the control group was given nCPAP. The respiratory rate, transcutaneous oxygen saturation (TcSO2), respiratory distress clinical score system (CSS) score, arterial partial pressure of oxygen (PaO2) and other respiratory related indicators before treatment and after treatment of 24 h and improvement of clinical symptoms and signs before and after treatment were compared between two groups. Results: The respiratory rate and CSS score of two groups significantly decreased after treatment of 24 h, and the degree of reduction was more obvious in the observation group. TcSO2 and PaO2 of two groups significantly increased after treatment of 24 h, and the ascending range in the observation group was significantly larger than that in the control group. After treatment, clinical symptoms of cough, lung rales and lung inflammation were improved in both groups. The disappearance time of symptoms and signs in the observation group was significantly shorter than that in the control group, with statistically significant differences (P<0.05). Conclusion: HFNC in respiratory support for children with severe bronchiolitis can significantly improve the ventilation function and clinical symptoms. The therapeutic effects of HFNC are better than that of nCPAP, and the sample size could be enlarged for further observation.