| 孔 菲,杨 慧,任 芳,吕月华,赵 丽.经鼻加温加湿高流量吸氧对重症肺炎伴呼吸衰竭患儿血气指标、肺功能及细胞因子水平的影响[J].,2023,(17):3258-3262 |
| 经鼻加温加湿高流量吸氧对重症肺炎伴呼吸衰竭患儿血气指标、肺功能及细胞因子水平的影响 |
| Effects of Heated Humidified High-flow Nasal Cannula on Blood Gas Index, Lung Function and Cytokine Level in Children with Severe Pneumonia with Respiratory Failure |
| 投稿时间：2023-03-07 修订日期：2023-03-28 |
| DOI：10.13241/j.cnki.pmb.2023.17.011 |
| 中文关键词: 重症肺炎 呼吸衰竭 经鼻加温加湿高流量吸氧 患儿 血气指标 肺功能 细胞因子 |
| 英文关键词: Severe pneumonia Respiratory failure Heated humidified high-flow nasal cannula Children Blood gas index Lung function Cytokine |
| 基金项目:江苏省妇幼健康科研项目（F20210527） |
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| 中文摘要: |
| 摘要 目的：观察经鼻加温加湿高流量吸氧（HFNC）对重症肺炎伴呼吸衰竭患儿血气指标、肺功能及细胞因子水平的影响。方法：选取南京医科大学附属儿童医院2020年3月~2022年3月期间收治的86例重症肺炎伴呼吸衰竭患儿，按照随机数字表法分为经鼻持续气道正压通气（nCPAP）组和HFNC组，各为43例。对比两组临床相关指标、血气指标、肺功能及细胞因子水平，同时观察两组镇静剂使用、预后及并发症发生情况。结果：HFNC组的机械通气时间、咳嗽缓解时间、肺部啰音消失时间、入住儿童重症监护室（PICU）时间均短于nCPAP组（P<0.05）。两组患儿治疗后心率（HR）升高，呼吸频率（RR）下降，且HFNC组的变化大于nCPAP组（P<0.05）。两组患儿治疗后pH值、血氧分压（PO2）、血氧饱和度（SpO2）、氧合指数（OI）均升高，且HFNC组高于nCPAP组（P<0.05）。两组患儿治疗后用力肺活量（FVC）、1s用力呼气容积（FEV1）、用力呼气时最高呼气流速（PEF）升高，且HFNC组高于nCPAP组（P<0.05）。两组患儿治疗后降钙素原（PCT）、白细胞介素（IL-6）和肿瘤坏死因子（TNF-α）下降，且HFNC组低于nCPAP组（P<0.05）。HFNC组镇静剂使用、再住院例数均少于nCPAP组（P<0.05）。两组死亡例数、并发症发生率组间对比未见统计学差异（P>0.05）。结论：HFNC可有效缓解重症肺炎伴呼吸衰竭患儿的临床症状，改善血气指标、肺功能及细胞因子水平。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of heated humidified high-flow nasal cannula (HFNC) on blood gas index, lung function and cytokine level in children with severe pneumonia with respiratory failure. Methods: 86 children with severe pneumonia with respiratory failure who were admitted to Children's Hospital Affiliated to Nanjing Medical University from March 2020 to March 2022 were selected, and they were divided into nasal continuous positive airway pressure (nCPAP) group and HFNC group according to random number table method, with 43 cases in each group. The clinical related indexes, blood gas indexes, lung function and cytokine levels were compared in the two groups, and the sedative use, prognosis and complications were observed in the two groups. Results: The mechanical ventilation time, cough relief time, lung rales disappearance time and hospitalization time in children's intensive care unit (PICU) in the HFNC group were shorter than those in the nCPAP group (P<0.05). Heart rate (HR) increased, and respiratory rate (RR) decreased in the two groups after treatment, and the changes in the HFNC group were greater than those in the nCPAP group (P<0.05). After treatment, pH value, blood oxygen partial pressure (PO2), blood oxygen saturation (SpO2) and oxygenation index (OI) in the two groups increased, and HFNC group was higher than nCPAP group (P<0.05). After treatment, forced vital capacity (FVC), 1s forced expiratory volume (FEV1) and maximum expiratory flow rate (PEF) during forced expiratory in the two groups increased, and HFNC group was higher than nCPAP group (P<0.05). After treatment, procalcitonin (PCT), interleukin (IL-6) and tumor necrosis factor (TNF-α) in the two groups decreased, and HFNC group was lower than nCPAP group (P<0.05). The number of sedative use and re-hospitalization in the HFNC group was lower than that in the nCPAP group (P<0.05). There were no significant differences in the number of deaths and incidence of complications in the two groups (P>0.05). Conclusion: HFNC can effectively relieve the clinical symptoms of severe pneumonia with respiratory failure, and improve blood gas indexes, lung function and cytokine levels in children. |
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