密闭式吸痰联合俯卧位通气对重症腺病毒肺炎患儿的影响

目的探讨密闭式吸痰联合俯卧位通气对重症腺病毒肺炎患儿的疗效观察。方法选取我院2019年2—8月收治的60例重症腺病毒肺炎患儿为研究对象,将患儿随机等分为对照组和观察组。对照组给予俯卧位通气联合开放式吸痰,观察组给予俯卧位通气联合密闭式吸痰。比较治疗前后两组患儿血气分析指标、机械通气参数、住院期间总的机械通气时间、ICU住院时间、呼吸机相关性肺炎(VAP)发生率及28 d全因病死率。结果治疗后第1天观察组血乳酸水平低于对照组(P<0.05);治疗后第3,7天观察组PO 2,PO 2/FiO 2高于对照组(P<0.05);观察组住院期间总的机械通气时间、ICU住院时间短于对照组(P<0.05),VAP发生率低于对照组(P<0.05);两组患儿28 d全因病死率比较差异无统计学意义(P>0.05)。结论密闭式吸痰联合俯卧位通气可有效改善重症腺病毒肺炎患儿肺通气、氧合状态,降低VAP发生率,缩短机械通气时间、住院时间,值得在临床中推广应用。

Effect of closed sputum suction combined with prone position ventilation for children patients with severe adenovirus pneumonia

Objective To explore the observation of curative effect of closed sputum suction combined with prone position ventilation for children patients with severe adenovirus pneumonia.Methods To select 60 cases of children patients with severe adenovirus pneumonia admitted to our hospital from February to August 2019 as the study subjects.The children patients were randomly divided into a control group and an observation group.The control group was given prone position ventilation combined with open sputum suction,and the observation group was given prone position ventilation combined with closed sputum suction to compare the analysis indexes of blood gas,parameters of mechanical ventilation,total mechanical ventilation time during hospitalization,ICU hospitalization time,incidence of ventilator associated pneumonia(VAP)and 28-day all-cause mortality rate between the two groups before and after treatment.Results On the first day after treatment,the blood lactate level of the observation group was lower than that of the control group(P<0.05).On the 3rd and 7th day after treatment,the PO 2 and PO 2/FiO 2 in the observation group were higher than those in the control group(P<0.05).The total mechanical ventilation time during hospitalization and ICU hospitalization time in the observation group were shorter than those in the control group(P<0.05),and the incidence of VAP was lower than that in the control group(P<0.05).There was no significant difference in 28-day all-cause mortality rate between the two groups(P>0.05).Conclusion The application of closed sputum suction combined with prone position ventilation could effectively improve the pulmonary ventilation and oxygenation status of children patients with severe adenovirus pneumonia,reduce the incidence of VAP,shorten the time of mechanical ventilation and hospitalization.It was worthy of clinical promotion and application.