面罩无创正压通气治疗百草枯中毒的临床研究  

Clinical research of mask NIPPV in the treatment of paraquat poisoning

作　　者：曹春水[1] 黄亮[1] 殷勤[1] 占钻[1] 吴天明[1] 杨继斌[1] 熊华威[1] 

机构地区：[1]南昌大学第一附属医院急诊科,江西南昌330006

出　　处：《中国急救医学》2010年第10期927-930,共4页Chinese Journal of Critical Care Medicine

基　　金：基金项目：江西省卫生厅科技计划项目（No.20081023）

摘　　要：目的 探讨面罩无创正压通气（NIPPV）在治疗百草枯中毒呼吸衰竭时对自由基产生的影响.方法 观察面罩无创正压通气、氧疗、非氧疗治疗百草枯中毒患者的血气变化,将吸入氧浓度（FiO2）及动脉血氧分压与血清超氧化物歧化酶（SOD）、丙二醛（MDA）以及血生化指标进行相关性分析,记录生存时间和病死率.结果 各组患者FiO2、PaO2的改变与SOD、MDA的变化无相关性,而PaO2与Cr、AST、CK及CK-MB呈负相关（r=-0.89,P〈0.05）,NIPPV治疗组2周以上生存数明显高于其他两组,三者总死亡率比较差异无统计学意义.结论 NIPPV治疗未明显加剧自由基损伤,可以用于百草枯中毒呼吸衰竭的辅助治疗.Objective To investigate the effect of noninvasive positive pressure ventilation （NIPPV） on the production of free radicals when NIPPV was applied in the treatment of paraquat posioning induced respiratory failure. Methods Changes of blood gas in patients of mask NIPPV group, oxygen therapy group and non oxygen therapy group were observed, correlation analysis was conducted between fraction of inspired oxygen （ FiO2 ）, arterial partial pressure of oxygen （ PaO2 ） and serum superoxide dismutase （ SOD）, malondialdehyde （MDA） and blood biochemical markers, survival time and fatality rate was recorded. Results There was no correlation between the changes of FiO2, PaO2 and SOD, MDA, but PaO2 was correlated negatively with Cr, AST, CK and CK- MB（r = -0.89, P 〈 0. 05 ） in all groups, compared with another two groups, survival rate more than two weeks in patients of NIPPV group was obviously higher, there was no significant difference in total death rate among three groups. Conclusion NIPPV wouldn＇t obviously aggravate free radical injury and could be applied as adjunctive therapy in the treatment of paraquat posioning induced respiratory failure.

关 键 词：面罩无创正压通气 百草枯 中毒 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]