2022 年第 12 期 第 17 卷

百日咳相关性重症肺炎患儿行有创机械通气的影响因素分析

Influencing factors of invasive mechanical ventilation in children with pertussis associated severe pneumonia

作者：程远1解启莲2赵胜3郑丽云3

英文作者：Cheng Yuan1 Xie Qilian2 Zhao Sheng3 Zheng Liyun3

单位：1安徽医科大学附属省儿童医院感染科，合肥230022；2安徽医科大学附属省儿童医院急诊科，合肥230022；3安徽医科大学附属省儿童医院心内科，合肥230022

英文单位：1Department of Infectious Disease Anhui Provincial Children′s Hospital of Anhui Medical University Hefei 230022 China; 2Department of Emergency Anhui Provincial Children′s Hospital of Anhui Medical University Hefei 230022 China; 3Department of Cardiology Anhui Provincial Children′s Hospital of Anhui Medical University Hefei 230022 China

关键词：百日咳；重症肺炎；有创机械通气；影响因素

英文关键词：Pertussis;Severepneumonia;Invasivemechanicalventilation;Influencefactor

• 摘要：

• 目的  探讨百日咳相关性重症肺炎患儿行有创机械通气的影响因素。方法  选择2019年5月至2022年5月安徽医科大学附属省儿童医院感染科收治的130例百日咳相关性重症肺炎患儿，根据是否行有创机械通气将患儿分为有创机械通气组（观察组）与非有创机械通气组（对照组）。比较2组患儿临床资料，采用Logistic回归法分析患儿有创机械通气的影响因素。结果  130例百日咳相关性重症肺炎患儿中，接受有创机械通气治疗患儿39例，占30.0%，作为观察组，其余91例患儿作为对照组。2组年龄、早产、基础疾病、全程接种疫苗、呼吸困难、并发症、肺不张比例、白细胞计数、血红蛋白水平比较，差异均有统计学意义（均P＜0.05）。Logistic回归分析结果显示，年龄、早产、基础疾病、呼吸困难、白细胞计数、并发症、肺不张是百日咳相关性重症肺炎患儿有创机械通气的危险因素（比值比=1.781、2.024、2.151、2.054、1.067、4.125、3.893，95%置信区间：1.046～8.236、1.212～6.355、1.064～7.431、1.195～9.935、1.002～1.217、1.345～10.783、1.068～9.532，均P＜0.05），全程接种疫苗、血红蛋白是患儿有创机械通气的保护因素（均P＜0.05）。结论  百日咳相关性重症肺炎患儿行有创机械通气的影响因素较多，应及时采取相应干预措施，以降低有创机械通气使用率。

• Objective  To explore the influencing factors of invasive mechanical ventilation in children with pertussis associated severe pneumonia. Methods  From May 2019 to May 2022, 130 children with pertussis associated severe pneumonia admitted to Department of Infectious Disease, Anhui Provincial Children′s Hospital of Anhui Medical University were selected. According to whether children were treated with invasive mechanical ventilation, they were divided into invasive mechanical ventilation group (observation group) and non-invasive mechanical ventilation group (control group). The clinical data of the two groups were compared, and the influencing factors of invasive mechanical ventilation were analyzed by Logistic regression analysis. Results  Among 130 children with pertussis associated severe pneumonia, 39 children received invasive mechanical ventilation, accounting for 30.0%, and were divided into the observation group. Other 91 children were divided into the control group. There were significant differences in age, proportions of premature delivery, basic diseases, whole course vaccination, dyspnea, complications, atelectasis, white blood cell count, and hemoglobin between the two groups (all P＜0.05). Logistic regression analysis showed that age, premature delivery, basic diseases, dyspnea, white blood cell count, complications and atelectasis were risk factors for invasive mechanical ventilation in children with pertussis associated severe pneumonia (odds ratio=1.781, 2.024, 2.151, 2.054, 1.067, 4.125, 3.893, 95% confidence interval: 1.046-8.236, 1.212-6.355, 1.064-7.431, 1.195-9.935, 1.002-1.217, 1.345-10.783, 1.068-9.532, all P＜0.05). Whole course vaccination and hemoglobin were the protective factors of invasive mechanical ventilation in children (both P＜0.05). Conclusion  There are many related factors influencing the use of invasive mechanical ventilation in children with pertussis associated severe pneumonia. Corresponding intervention measures should be taken in time to reduce the use rate of invasive mechanical ventilation.