无创正压通气在肺功能中重度损害患者开胸手术后的应用  

Noninvasive Positive-pressure Ventilation in Patients with Preoperative Moderate-severe Respiratory Dysfunction after Thoracotomy

作　　者：陈剑[1] 李根水[1] 周新涛[1] 杜少鸣[1] 刘建[1] 

机构地区：[1]安徽医科大学附属安庆医院心胸外科,安徽安庆246003

出　　处：《中国临床医学》2010年第4期499-500,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨序贯无创正压通气在肺功能中重度损害患者开胸手术后的应用价值。方法:回顾分析2004年10月—2008年10月,68例肺功能中重度损害开胸手术患者的临床资料。其中,A组为拔除气管插管后序贯给予呼吸机无创正压通气患者,B组为拔除气管插管后未使用呼吸机治疗患者。观察两组术后心肺并发症的发生率,拔除气管插管后再插管率或气管切开率以及病死率。结果:A组和B组术后心肺并发症的发生率分别为25%和56.25%;再次气管插管或气管切开率分别为8.33%和43.75%;术后病死率分别为2.78%和18.75%;两组比较有显著性差异(P<0.05)。结论:开胸手术后序贯无创正压通气可以减少开胸手术后心肺并发症、再插管或气管切开及致死性并发症。Objective：To determine the effect of sequential noninvasive positive-pressure ventilation on patients with preoperative moderate-severe respiratory dysfunction after thoracotomy.Methods： A retrospective study was performed.Sixty-eigth patients with preoperative moderate-severe respiratory dysfunction underwent thoracotomy between October 2004 and October 2008 in our hospital.Patients in Group A were noninvasive positive-pressure ventilated after extubation,while patients in Group B were not.The incidence of postoperative cardiac-pulmonary complications,the rate of reintubation or tracheotomy,and the mortality were compared.Results： The incidence of postoperative cardiac-pulmonary complications were 25% and 56.25% in Group A and Group B,respectively.The rate of reintubation or tracheotomy were 8.33% and 43.75%,and the mortality were 2.78% and 18.75% in Group A and Group B,respectively.There were significant differences between the two groups（P0.05）.Conclusions： Sequential noninvasive positive-pressure ventilation early after thoracotomy can reduce the incidence of postoperative cardiac-pulmonary complications,the rate of reintubation or tracheotomy and the incidence of fatal complications.

关 键 词：无创正压通气 肺功能 开胸手术 

分 类 号：R655[医药卫生—外科学]