序贯通气治疗急性有机磷中毒所致呼吸衰竭的临床研究  

A study of sequential mechanical ventilation in treating patients with acute orgnaophosphorus pesticides poisoning complicated with respiratory failure

作　　者：李霞[1] 史忠[1] 周坤[1] 刘波[1] 尤在春[1] 卢玉宝[1] 

机构地区：[1]第三军医大学新桥医院急救部,重庆400037

出　　处：《重庆医学》2008年第22期2522-2523,共2页Chongqing medicine

摘　　要：目的探讨有创-无创序贯通气在抢救急性有机磷中毒所致呼吸衰竭中的作用。方法将2003～2008年收治的86例重度有机磷中毒并发呼吸衰竭患者分为序贯通气组(46例)与有创通气组(40例),对患者总机械通气时间、有创通气时间、呼吸机相关肺炎(VAP)发生率和病死率进行对比分析。结果与有创通气组比较,序贯通气组有创通气时间显著缩短(P<0.05),VAP发生率明显下降(P<0.01),病死率亦明显降低(P<0.05)。结论有创-无创序贯通气策略可通过缩短有创通气时间和降低VAP发生率,纠正急性有机磷中毒所致呼吸衰竭,具有肯定的临床疗效。Objective To investigate the effect of sequential mechanical ventilation on respiratory failure complicated by acute orgnaophosphorus pesticides poisoning. Methods Eighty-six cases of acute orgnaophosphorus pesticides poisoning from 2003 to 2008 were divided into sequential mechanical ventilation group （n=46） and invasive positive pressure ventilation （IPPV） group （n = 40）. Of them, 46 patients received the sequential mechanical ventilation and 40 patients received invasive positive pressure ventilation （IPPV）. The mechanical ventilation duration,invasive ventilation duration,incidence and case-fatality rate of ventilator associated pneumonia （VAP） were measured and analyzed. Results Compared with IPPV group,sequential mechanical ventilation group had shorter duration of IPPV,lower rate of VAP and case-fatality. Conclusion The sequential mechanical ventilation is more effective in patients with acute orgnaophosphorus pesticides poisoning complicated with respiratory failure by shortening the time of IP- PV and decreasing the rate of VAP.

关 键 词：有机磷中毒 呼吸衰竭 机械通气 序贯通气 

分 类 号：R595.4[医药卫生—内科学] R459.6[医药卫生—临床医学]