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目的:探讨高原地区小儿重症肺炎的发病特点及缺氧对心肌的损害,肺通透性的改变、血氧饱和度的影响。方法:收集1998年1月—2005年2月出生的3个月～3岁救治病例68例,根据主要临床表现,采用动态心电图观察,分析心率呼吸变化,测定血气分析;比较胸部X-ray表现,监测血电解质改变。结果:68例中心电图改变占84.7%,血气表现:pH值普遍降低,PO2降低,SaO2明显降低,PCO2一定程度升高。电解质主要表现低钾、低钠血症。X-ray提示早、中期既有肺内小点片状融合阴影,模糊的间质水肿,个别有肺不张、肺膨胀不全,恢复期病变吸收缓慢。结论:高原低氧是使婴幼儿肺炎加重的主要因素,同时使体内动脉血气改变,电解质紊乱,缺氧性肺动脉高压,早期发生呼吸衰竭。通畅呼吸、充分供氧是治疗成功的关键。
Objective: To investigate the incidence of severe pneumonia in children in the plateau and hypoxia damage to the myocardium, pulmonary permeability changes, the effect of oxygen saturation. Methods: A total of 68 cases of patients aged 3 months to 3 years old who were born between January 1998 and February 2005 were collected. According to the main clinical manifestations, the changes of heart rate and respiration were analyzed by dynamic electrocardiogram. Blood gas analysis was performed. , Monitoring blood electrolyte changes. Results: 68 cases of ECG changes accounted for 84.7%, blood gas performance: generally lower pH, PO2 decreased SaO2 decreased significantly, PCO2 increased to some extent. Electrolytes mainly low potassium, hyponatremia. X-ray tips early and mid-term both small intrapulmonary patchy fusion shadow, blurred interstitial edema, some have atelectasis, pulmonary dilatation, recovery of slow absorption of the disease. Conclusion: Hypoxia at high altitude is a major factor that aggravates pneumonia in infants and young children. At the same time, it causes changes of arterial blood gas, electrolyte imbalance, hypoxic pulmonary hypertension and early respiratory failure. Breathing open, full oxygen is the key to successful treatment.