无创正压通气治疗急性肺损伤的临床效果

发布时间：2018-04-15 03:01

本文选题：无创正压通气 + 急性肺损伤　；参考：《广东医学》2014年14期

【摘要】：目的观察无创正压通气(NIPPV)治疗急性肺损伤(ALI)的临床效果。方法选取因各种病因发生ALI的患者50例,分成A、B两组各25例。两组患者均给予常规系统治疗,此外B组给予高流量氧疗,A组早期行NIPPV支持,观察并比较两组患者的病情变化、血气分析、进展为急性呼吸窘迫综合征(ARDS)例数、呼吸机相关性肺炎(VAP)例数、死亡例数、机械通气时间及住院时间等指标。结果 (1)通气前两组患者PaO2、pH、PaCO2及RR水平差异均无统计学意义(P0.05),通气2 h后PaO2、PaCO2、RR水平与通气前比较差异有统计学意义(P0.05),通气48 h与脱机24 h后PaO2、pH值、PaCO2及RR水平均较通气前差异有统计学意义(P0.05),但同期组间比较差异无统计学意义(P0.05)。(2)A组进展为ARDS例数、VAP例数、死亡例数、机械通气时间、住院时间及住院费用均明显低于B组,差异有统计学意义(P0.01)。结论 NIPPV治疗ALI可有效减少气管插管率、缩短住院时间,降低临床病死率,且具有一定经济学价值。
[Abstract]:Objective to observe the clinical effect of non-invasive positive pressure ventilation (NIPPVV) in the treatment of acute lung injury (Ali).Methods 50 patients with ALI were divided into two groups: group A (n = 25) and group B (n = 25).Patients in both groups were given routine systemic therapy, and group B received NIPPV support at the early stage of high flow oxygen therapy. The patients' condition, blood gas analysis and progression to acute respiratory distress syndrome (ARDS) were observed and compared.Ventilator-associated pneumonia (VAP), death, mechanical ventilation time and hospital stay.Results (1) there was no significant difference in Paco _ 2 and RR levels between the two groups before and after ventilation. There was a significant difference in Pao _ 2 Paco _ 2C _ 2C _ 2C _ 2 and Pao _ 2 PCO _ 2P _ (0.05) after 2 hours of ventilation. Paco _ 2 and RR were significantly higher than those before ventilation at 48 h after ventilation and 24 h after weaning.The former difference was statistically significant (P 0.05), but there was no significant difference between the two groups in the same period. The progression of ARDS in group A was as follows: (1) the number of patients with ARDS was higher than that of group A (P < 0. 05), but there was no significant difference between the two groups.The number of deaths, the time of mechanical ventilation, the duration of hospitalization and the cost of hospitalization were significantly lower than those in group B (P 0.01).Conclusion NIPPV can effectively reduce the rate of endotracheal intubation, shorten the hospital stay, and reduce the clinical mortality.
【作者单位】：广东省中山市人民医院呼吸内科;
【分类号】：R563.8

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