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Clinical role of monitoring of oxygenation index and alveolar arterial oxygen partial pressure difference in children with severe pneumonia |
YANG Yi′nan WANG Haiyan Chaolumen Qiqige |
Department of Pediatrics, the Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Autonomous Region, Huhhot 010050, China |
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Abstract Objective To explore the clinical role of monitoring of oxygenation index (OI) and Alveolar arterial oxygen partial pressure difference (A-aDO2) for children with severe pneumonia. Methods The clinical data of 71 children with severe pneumonia who had been seeking treatment in the Affiliated Hospital of Inner Mongolia Medical University from March 2016 and March 2017 were set as the study group, and according to the acute physiology and chronic health evaluation (APACHE-Ⅱ) scores, these patients were divided into study group A (≥40 points), the study group B (20 -<40 points) and study group C (<20 points). Another 71 healthy children were selected during the same period as the control group. Blood gas monitoring was carried in all the three groups. The OI/endothelial surface area, A-aDO2/endothelial surface area at difference time periods, and prognosis in the three study groups were compared. Results The OI/endothelial surface area was registered at in study group A, in study group B and in study group C, all lower than the control group, and the study group A was the lowest, where the differences were statistically significant (P < 0.01). The A-aDO2/endothelial surface area in study group A, study group B, and study group C were higher than that in the control group, and the study group A was the highest (P < 0.01). The OI/endothelial surface area increased over the treatment time, whereas the A-aDO2/endothelial surface area decreased over the treatment time. All of the above differences were statistically significant (P < 0.01). Out of the 71 cases of children with severe pneumonia, 70 cases survived and 1 died. Conclusion For children with severe pneumonia, dynamic monitoring of OI and A-aDO2 can assess their conditions, thus providing guidance for its clinical treatment and prognosis improvement. Therefore, it is of significant value to be popularized in clinical application.
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[1] 王玉瑛,韩波,高怡玢,等.早期CPAP对小儿重症肺炎并呼吸衰竭血气指标及预后的影响[J].临床肺科杂志,2016,21(1):75-78.
[2] 李茂霞,万朝敏.婴幼儿重症肺炎的临床特点及死亡相关因素研究[J].中国小儿急救医学,2015,22(2):113-118.
[3] 程剑剑,秦秉玉,马利军,等.适应性支持通气对老年重症肺炎机械通气患者呼吸力学参数的影响[J].中华老年医学杂志,2014,33(10):1075-1077.
[4] 张婷,曲书强.实验室监测指标对评估儿童重症肺炎病情及预后意义的研究进展[J].中国小儿急救医学,2015, 22(12):865-868.
[5] 曾文新,黄园,邓郁,等.真菌(1,3)-β-D葡聚糖检测在重症肺炎患者中真菌检测的临床价值[J].中华急诊医学杂志,2016,25(5):659-662.
[6] 刘伟,彭丽萍,华树成.动态监测重症肺炎患者血乳酸、氧合指数及C反应蛋白的临床意义[J].国际呼吸杂志,2015,35(14):1048-1051.
[7] 戎群芳,张育才,徐梁,等.重症肺炎并呼吸衰竭患儿动态无创肺动脉压力监测及其意义[J].中华实用儿科临床杂志,2015,30(4):271-274.
[8] 周灿,朱小莉,王红萍.不同体位对重症肺炎口插管老年患者动脉氧分压的影响[J].中华现代护理杂志,2014,20(12):1414-1415.
[9] 蒋海珍.小剂量多巴胺联合多巴酚丁胺在重症肺炎患儿中的临床效果分析[J].中华全科医学,2016,14(1):90-92.
[10] 张丽,郝现伟,李小亮,等.肺泡-动脉氧分压差和氧合指数动态监测在小儿重症肺炎中的应用价值[J].儿科药学杂志,2017,23(1):3-7.
[11] 杨日焰,陈杏波,刘汉冕,等.重症肺炎液体复苏患者乳酸清除率、氧合指数与预后相关性研究[J].临床和实验医学杂志,2016,15(12):1149-1151.
[12] 田雨,李杨.合理行液体监测管理在保护重症肺炎患者中的应用价值[J].临床肺科杂志,2015,20(5):886-888.
[13] 王静,程玮,张雯,等.重症肺炎患儿感染病原菌分布及其对肺功能的影响研究[J].中华医院感染学杂志,2016, 26(15):3562-3563,3566.
[14] 张志强,马海英,冯宪军,等.重症肺炎合并重度急性呼吸窘迫综合征患者临床特点与预后影响因素分析[J].中华医院感染学杂志,2016,26(6):1297-1299.
[15] 范徐威.俯卧位机械通气辅助药物治疗小儿重症肺炎临床观察[J].现代诊断与治疗,2017,28(1):43-45.
[16] 莫新,唐皓,曾丽金,等.血清胆碱酯酶含量对重症肺炎患者病情和预后的评估价值[J].中华危重病急救医学,2016,28(1):38-43.
[17] 侯鸿雁,黄付甲,陆春云.鼻塞式持续气道正压通临床疗效及安全性分析[J].实用心脑肺血管病杂志,2015, 23(12):74-76.
[18] 王小琳,史金英,柴书坤,等.静动脉二氧化碳分压差对重症肺炎患者预后影响[J].临床误诊误治,2016,29(5):88-91.
[19] 郑宏,温燕,郭琳,等.呼吸机相关性肺炎患者氨溴索联合振动排痰机应用的效果评价[J].中华医院感染学杂志,2015,30(10):2259-2261.
[21] 王素芳,韩富根,成怡冰,等.小儿呼吸道异物术前发生急性呼吸功能不全的危险因素分析[J].中华耳鼻咽喉头颈外科杂志,2014,49(11):925-929.
[22] 苗慧慧,杨立明,张艳丽.P(A-a)O2与CVP在重症心力衰竭机械通气病人撤机中的预测作用研究[J].中西医结合心 脑血管病杂志,2016,11(11):1263-1265.
[23] 彭勇,张艳.低分子肝素治疗对老年重症肺炎患者动脉血气及近期预后的影响[J].临床肺科杂志,2016,21(5):816-818.
[24] Scicluna BP,van Vught LA,van der Poll T,et al. Reply:FAIM3 PLAC8 Ratio Compared with Existing Biomarkers for Diagnosis of Severe Community-acquired Pneumonia:Comparing Apples to Oranges [J]. Am J Respir Crit Care Med,2016,193(1):102-103.
[25] 卢善翃,李俊辉,欧阳莎,等.重症病毒性肺炎合并急性呼吸窘迫综合征的预后危险因素分析[J].中国呼吸与危重监护杂志,2014,13(6):560-564.
[26] 邓英,唐霞,张雪琼,等.鼻塞式持续气道正压通气治疗高原地区重症肺炎患儿效果及对血气指标的影响[J].疑难病杂志,2017,16(11):1123-1126.
[27] 张晓良,张晋莲.早期、间歇CPAP治疗小儿重症肺炎的临床研究[J].中国医学创新,2017,14(7):23-26. |
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