摘要
目的观察无创双水平气道正压通气模式(NBiPAP)在婴儿重症肺炎患者治疗中的近期疗效观察及对心脏标志物的影响。方法选取淄博市妇幼保健院PICU 2019年1月至2023年12月收治的125例婴儿重症肺炎患者,以随机数字表法分组为3组,一般氧疗组、无创持续气道正压通气(CPAP)组和双水平组,其中一般氧疗组35例(给予面罩吸氧),CPAP组50例(给予无创持续气道正压通气),双水平组40例(给予NBiPAP),统计肺部体征消失时间、呼吸困难消失时间、治疗有效率、气管插管率及氧疗前后(氧疗前及氧疗后3 d、5 d)的心脏标志物[N端前脑钠肽(NT-proBNP)、肌红蛋白(MYO)、肌钙蛋白I(cTnI)及肌酸激酶同工酶MB(CK-MB)]数据。结果双水平组肺部体征消失时间、呼吸困难消失时间均短于一般氧疗组,治疗有效率高于一般氧疗组(P<0.05)。双水平组在短期内对NT-proBNP、MYO、CK-MB改善效果明显,短期内呈现下降趋势,CPAP组在CK-MB的改善上与双水平组类似,在MYO改善上呈现先增后降趋势;而3组cTnI均呈现短期内渐增趋势。双水平组NT-proBNP、MYO改善效果优于CPAP组及一般氧疗组。双水平组及CPAP组对CK-MB改善效果优于一般氧疗组。结论相较于其他无创氧疗方式,NBiPAP模式应用于婴儿重症肺炎能短期内降低心脏标志物数值(NT-proBNP、MYO、CK-MB),改善心功能及心肌损伤,改善呼吸困难症状、减轻肺部体征,提高治疗有效率,效果优于CPAP模式和一般氧疗模式。
Objective To observe the short-term efficacy of NBiPAP in the treatment of infants with severe pneumonia and its impact on cardiac markers.Methods In this study,125 infants diagnosed with severe pneumonia and admitted to the PICU of Zibo Maternal and Child Health Hospital from January 2019 to December 2023 were randomized into three groups via a random number table:conventional oxygen therapy group(35 cases,receiving mask oxygen therapy),CPAP group(50 cases,receiving non-invasive continuous positive airway pressure),and bi-level group(40 cases,receiving NBiPAP).The disappearance time of pulmonary signs and dyspnea,treatment efficiency,intubation rate,and cardiac markers(NT-proBNP,MYO,cTnI,and CK-MB)before oxygen therapy and at 3 days,and 5 days after oxygen therapy were statistically analyzed.Results The bi-level group significantly shortened the disappearance time of pulmonary signs and dyspnea,and achieved a higher treatment efficiency than the conventional oxygen therapy group(P<0.05).Short-term assessment revealed superior efficacy for BiPAP in reducing levels of NT-proBNP and MYO compared to CPAP and conventional oxygen therapy.Both BiPAP and CPAP elicited a favorable response in CK-MB reduction,outperforming conventional therapy.Conversely,a consistent short-term increase in cTnI was noted across all groups.Conclusions Compared to other non-invasive oxygen therapies,NBiPAP application in infants with severe pneumonia can reduce cardiac marker levels(NT-proBNP、MYO、CK-MB),improve cardiac function and myocardial injury,alleviate dyspnea symptoms and pulmonary signs,and enhance treatment efficiency,with outcomes superior to CPAP and conventional oxygen therapy.
作者
司书红
侯建
李晓娟
杨艳辉
陈莉萍
巩雪
SI Shuhong;HOU Jian;LI Xiaojuan;YANG Yanhui;CHEN Liping;GONG Xue(PICU of Pediatrics,Zibo Maternal and Child Health Hospital,Shandong Province,Zibo,Shandong 255000,China)
出处
《中国医药指南》
2025年第31期20-24,共5页
Guide of China Medicine
基金
淄博市医药卫生科研项目立项(20230601069)。
关键词
重症肺炎
双水平气道正压通气
心脏标志物
婴儿
Severe pneumonia
Noninvasive bi-level positive airway pressure
Cardiac markers
Infants
