无创正压机械通气治疗小儿急性呼吸衰竭的临床研究

无创正压机械通气治疗小儿急性呼吸衰竭的临床研究
张笃飞;廖锋;曾霞;蔡露良;马志超;孙嵩
【期刊名称】《海南医学》
【年(卷),期】2013(24)15
【摘要】Objective To explore the risk factors associated with development of noninvasive positive pressure ventilation (NIPPV) failure in children with acute respiratory failure (ARF).Methods A total of 96 children with ARF treated with NIPPV,who were admitted to Pediatric Intensive Care Unit of People's Hospital of Hainan Province from Jun.2009 to Jun.2012,were divided into NIPPV success group and NIPPV failure group.Logistic regression analysis was performed on the clinical data.Results NIPPV success group consisted of 61 cases,and NIPPV failure group consisted of 35 cases.There were significant differences between the two groups in interstitial pneumonia,neurogenic pulmonary edema,arterial carbon dioxide tension (PaCO2) before NIPPV,respiratory index (RI),APACHE Ⅱ score and PaCO2 after 1 hour NIPPV.Neurogenic pulmonary
edema,RI,APACHE Ⅱ score and PaCO2 after 1 hour NIPPV were risk factors for the development of NIPPV failure in children with ARF by logistic regression analysis.Conclusion Neurogenic pulmonary edema,respiratory index,APACHE Ⅱ score and PaCO2 after 1 hour NIPPV are the risk factors for the development of NIPPV failure in children with ARF.%目的探讨无创正压机械通气(NIPPV)治疗小儿急性呼吸衰竭(ARF)失败的危险因素.方法 2009年6
月至2012年6月海南省人民医院儿科重症病房收治的96例由各种病因导致ARF 并且应用NIPPV治疗的患儿,按照治疗结果分为NIPPV成功组和NIPPV失败组,采用单因素和非条件Logistic回归分析对两组患儿的临床资料进行分析.结果NIPPV成功组61例,NIPPV失败组35例.治疗成功率为63.5％ (61/96).成功组NIPPV治疗1h后PaCO2与治疗前对比明显降低,差异有统计学意义,失败组NIPPV治疗1h后PaCO2与治疗前比较差异无统计学意义,与NIPPV治疗结果有关的6个变量是间质性肺疾病、神经源性肺水肿、上机前PaCO2、呼吸指数、APACHEⅡ评分和上机1h后的PaCO2.经去除各因素之间相互混杂的影响,仍然与NIPPV治疗结果有关的变量是:神经源性肺水肿、呼吸指数、APACHEⅡ评分和上机1h后PaCO2.结论神经源性肺水肿、呼吸指数、APACHEⅡ评分及上机1h后的PaCO2水平是NIPV治疗失败的危险因素.
【总页数】4页(P2224-2227)
【作者】张笃飞;廖锋;曾霞;蔡露良;马志超;孙嵩
【作者单位】海南省人民医院儿科,海南海口570311;海南省人民医院儿科,海南海口570311;海南省人民医院儿科,海南海口570311;海南省人民医院儿科,海南海口570311;海南省人民医院儿科,海南海口570311;海南省人民医院儿科,海南海口570311
【正文语种】中文
【中图分类】R725.6
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