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目的探讨呼吸机辅助通气治疗小儿急性肺损伤的临床效果。方法选取2013年4月-2015年4月达州市中心医院收治的急性肺损伤患儿80例,随机分为对照组和观察组,每组40例。对照组患儿采用常规对症治疗,观察组患儿在常规对症治疗基础上应用呼吸机辅助通气。比较两组患儿临床疗效及治疗前后呼吸频率、氧合指数、心率(HR)、氧分压(PaO_2)、二氧化碳分压(PaCO_2)、呼吸道阻力(Raw)。结果观察组患儿临床疗效优于对照组(P<0.05)。治疗前两组患儿呼吸频率、氧合指数比较,差异无统计学意义(P>0.05);治疗后观察组患儿呼吸频率低于对照组,氧合指数高于对照组(P<0.05)。治疗前后两组患儿HR、Raw比较,差异无统计学意义(P>0.05)。治疗后1、4 h,观察组患儿PaO_2高于对照组,PaCO_2低于对照组(P<0.05);不同时间点PaO_2、PaCO_2比较,差异有统计学意义(P<0.05);治疗方法和时间在PaO_2、PaCO_2上存在交互作用(P<0.05)。结论呼吸机辅助通气治疗小儿急性肺损伤的临床效果确切,可改善患儿呼吸频率和氧合指数。
Objective To investigate the clinical effect of ventilator-assisted ventilation on children with acute lung injury. Methods Eighty children with acute lung injury admitted from April 2013 to April 2015 in Dazhou Central Hospital were randomly divided into control group and observation group, 40 cases in each group. The control group of children with conventional symptomatic treatment, observation group of children on the basis of conventional symptomatic treatment using ventilator-assisted ventilation. The clinical efficacy and respiratory rate, oxygenation index, heart rate (HR), partial pressure of oxygen (PaO_2), partial pressure of carbon dioxide (PaCO_2) and respiratory resistance (Raw) were compared between the two groups. Results The clinical efficacy of observation group was better than that of control group (P <0.05). The respiratory rate and oxygenation index of the two groups before treatment were not significantly different (P> 0.05). After treatment, the respiratory rate of the observation group was lower than that of the control group, and the oxygenation index was higher than that of the control group (P <0.05) . There was no significant difference in HR and Raw between the two groups before and after treatment (P> 0.05). At 1 and 4 h after treatment, the PaO_2 in the observation group was higher than that in the control group, and the PaCO_2 was lower than that in the control group (P <0.05). PaO_2 and PaCO_2 at different time points showed significant difference (P <0.05) There was an interaction between PaO2 and PaCO2 (P <0.05). Conclusion Ventilator-assisted ventilation is effective in treating children with acute lung injury and can improve respiratory rate and oxygenation index in children.