手术后呼吸衰竭无创通气治疗效果的评价  

Respiratory and Circulating Effects of Noninvasive Positive Pressure Ventilation in the Post-operation Patients with Acute Respiratory Failure

作　　者：张民伟[1] 闫冰[1] 

机构地区：[1]福建医科大学附属厦门市第一医院综合ICU,350000

出　　处：《青海医药杂志》2005年第12期1-3,共3页Qinghai Medical Journal

摘　　要：目的:评价无创通气对手术后呼吸衰竭患者的呼吸循环功能的影响。方法:采用自身对照的方法,对手术后呼吸衰竭患者实施无创通气治疗,观察治疗前、治疗1小时和治疗3小时的呼吸循环指标,并进行统计学分析。结果:23例呼吸衰竭患者,治疗前和治疗中的氧合指标比较,PaO2、SpO2、PaO2/FiO2和呼吸频率均显著改善(P<0.01),循环指标的比较显示心率和血压都较治疗前的心动过速和高血压有显著的下降(P<0.01),34.8%患者在上机后1小时血压下降至低血压状态,经强心药、升压药和补液治疗后纠正,上机前、上机1小时和3小时的资料各自比较P<0.01。结论:无创通气对改善呼吸和提高肺泡氧合疗效确切,但对心功能和循环具有负性作用而导致低血压,可能的机理与正压通气后回心血量下降有关,应注意扬长避短。Objective： To study the respiratory and circulating changes of noninvasive positive pressure ventilation （NPPV） treatment in the post-operation patients with acute respiratory failure. Methods： The respiratory and circulating parameters were recorded and analyzed before and after 1, 3 hours treatment with NPPV in the post-operation patients with acute respiratory failure. SPSS 11.0 software did the statistics. Results： In 23 cases of the post- operation patients with acute respiratory failure, level of PaO2 ,SpO2 ,PaO2/FiO2 and RR were significantly improved during the NPPV treatment compared with the pre-NPPV （P 〈 0.01 ）. The heart rate and blood pres-sure were significantly dropped during the NPPV treatment compared with status of tachycardia and hypertension in the period of pre-NPPV （ P 〈 0.01 ）, It is interesting that the blood pressure were dropped into hypotension in 34.8% of patients during the initial treatment of NPPV and were retrieved by using intropic therapy, low dose vasopressors and fluid therapy. There was difference among the pre-NPPV,after 1,3 treated hour （P 〈0.01 ）. Condusions： It is enphasized that there is good improving effects of NPPV on respiratory function and pulmonary alveoli oxygenation, but NPPV also has a negative effect on cardiac and circulating function due to lead to hypotension corrected with decreased returning heart blood.

关 键 词：无创通气 手术后 低血压 

分 类 号：R563.8[医药卫生—呼吸系统]