无创正压通气治疗急性呼吸衰竭的疗效观察  

Clinical observation of noninvasive positive pressure ventilation in treatment of patients with acute respiratory failure

作　　者：樊满齐[1] 赵生涛[1] 张鸿玲[1] 刘翱[1] 徐志伟[1] 涂伟[1] 曾召平[1] 

机构地区：[1]成都军区昆明总医院呼吸内科,云南昆明650032

出　　处：《临床肺科杂志》2011年第7期989-991,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨无创正压通气(NPPV)在治疗急性呼吸衰竭(ARF)中的临床疗效。方法 216例各种原因引起ARF的患者在常规治疗的基础上进行NPPV,采用压力支持通气(PSV)加呼气末正压通气(PEEP)。比较治疗前后动脉血气变化、观察NPPV治疗成功率及病死率。结果 NPPV治疗后2 h、24 h PaCO2和pH与治疗前比较明显改善(P<0.01),PaO2变化无显著性差异。NPPV对慢性阻塞性肺病急性加重(AECOPD)及急性心源性肺水肿疗效显著,成功率高。而对肺炎及肺间质纤维化疗效较差。结论 NPPV治疗ARF疗效肯定,正确选择患者及上机时机,密切监测,动态决策,可提高呼吸衰竭的救治成功率。Objective To evaluate the clinical effect of noninvasive positive pressure ventilation（NPPV） in treatment of patients with acute respiratory failure（ARF）.Methods On the basis of conventional therapy,two hundred and sixteen patients of ARF were treated by NPPV which includes pressure support ventilation（PSV） and positive end-expiratory pressure（PEEP）.Changes in the blood gas analysis were compared between pre and post treatment.And the success and mortality rate were obersrved.Results There were significant improvements in PaCO2,pH at 2 hours,24 hours after treatment,but no difference in oxygenation.There was a significant effect for NPPV in patients with acute exacerbations of chronic obstructive pulmonary disease（AECOPD） and acute cardiogenic pulmonary oedema,While poorer outcomes in patients with pneumonia and pulmonary interstitial fibrosis.Conclusion NPPV is a real advance in the treatment of ARF,especially in the mild and moderate types.

关 键 词：无创正压通气 急性呼吸衰竭 

分 类 号：R563.8[医药卫生—呼吸系统]