根据肺泡-动脉氧压差调节呼吸机参数在重症肺炎患儿中的应用

目的:探讨根据肺泡-动脉氧压差调节呼吸机参数对重症肺炎患儿的临床应用意义。方法:108例重症肺炎患儿随机分为观察组和对照组，各54例，经确诊立即采取对症支持治疗；对照组常规采用呼吸机进行治疗，观察组患儿根据肺泡-动脉氧压差调节呼吸机参数。比较2组患儿的临床表现及治疗效果。结果:机械通气后1~24 h内各时间点观察组动脉血氧分压水平均明显高于对照组（P<0.01），而观察组患儿动脉血二氧化碳分压水平与对照组差异均无统计学意义（P>0.05）。观察组患儿的通气时间、pH和氧合指数均显著高于对照组（P<0.01）。观察组治疗的总有效率为92.59%，对照组总有效率70.37%，差异有统计学意义（P<0.01）。结论:根据患儿的肺泡-动脉氧压差实时进行调节呼吸机参数，根据患儿病情定位治疗强度，可提高临床治疗效果，降低并发症及病死率。

Application value of the respirator parameters regulated by the difference of pulmonary alveoli-artery oxygen pressure in children with severe pneumonia

Objective:To explore the clinical application value of the respirator parameters regulated by the difference of pulmonary alveoli-artery oxygen pressure in children with severe pneumonia. Methods:One hundred and eight children with severe pneumonia were randomly divided into the observation group and control group ( 54 cases each group ) , the patients were diagnosed and treated supportively. The control group and observation group were treated with common respirator and respirator with the parameter regulated by the difference of pulmonary alveoli-artery oxygen pressure,respectively. The treatment efficacy and clinical manifestation between two groups were compared. Results:During the 1 to 24 h of mechanical ventilation,the PaO2 levels in observation group was significantly higher than that in control group(P<0. 01),and the difference of the PaCO2 level between two groups was not statistically significant (P>0. 05). The ventilation time,pH and oxygenation index in observation group were significantly higher than those in control group (P<0. 01). The total effective rates in observation group and control group were 92. 59% and 70. 37%,respectively,the difference of which was statistically significant(P<0. 01). Conclusions:The respirator parameter regulated by the difference of pulmonary alveoli-artery oxygen pressure can improve the treatment efficacy,and reduce the complication and mortality of patients.