持续镇静在重症肺炎机械通气患儿中的应用价值研究

目的探讨持续镇静在重症肺炎机械通气患儿中的应用价值。方法将2008年1月—2012年6月我院收治的80例重症肺炎需要行机械通气的患儿随机分成对照组和观察组,各40例。对照组进行机械通气后,采取常规治疗手段;观察组在此基础上对患儿进行持续镇静。比较两组患儿动脉血气分析指标(pH、PaO2、PaCO2、SaO2)、机械通气相关性肺炎发生率、重复插管发生率、病死率及机械通气天数。结果机械通气后观察组患儿pH、PaCO2、PaO2及SaO2异常率低于对照组(P0.05);PaCO2低于对照组,PaO2和SaO2高于对照组(P0.05);机械通气相关性肺炎发生率、重复插管发生率、机械通气天数及病死率均低于对照组(P0.05)。结论持续镇静能有效改善重症肺炎机械通气患儿的异常动脉血气指标,降低不良事件,减少医疗费用,具有极高的临床应用价值。

Application Value of Continuous Sedation in the Severe Pneumonia Children with Mechanical Ventilation

Objective To investigate the value of continuous sedation in the severe pneumonia children with mechani- cal ventilation. Methods A total of 80 severe pneumonia children with mechanical ventilation admitted to our hospital from Jan- uary 2008 to June 2012 were randomly divided into control group and observation group, each of 40 cases. Control group was giv- en conventional treatment after mechanical ventilation; Observation group was given continuous sedation on the basis of conven- tional treatment. The arterial blood gas （ pH, PaO2, PaCO2 , SaO2 ）, incidence of ventilator - associated pneumonia and re- peat intubation, mortality, days of mechanical ventilation were compared between two groups. Results After mechanical venti- lation, the abnormal rate of pH, PaO2, PaCO2 and SaO2 in the observation group were lower than those of control group （P 〈 0. 05 ） ; PaCO2 was lower than that of control group, PaO2 and SaO2 were higher than those of control group （P 〈 0.05 ） ; the in- cidence of ventilator - associated pneumonia and repeat intubation, mortality and days of mechanical ventilation were lower than those of control group （P 〈 0.05）. Conclusion Continuous sedation can effectively improve abnormal arterial blood gas, re- duce adverse events and medical costs in severe pneumonia children with mechanical ventilation, having a high clinical value.