无创及有创正压通气治疗光气中毒致急性呼吸窘迫综合征的疗效比较  

Efficac comparison of non-invasive and invasive positive pressure ventilation in treatment of acute respiratory distress syndrome caused by phosgene poisoning

作　　者：尉玉杰[1] 王磊[1] 井慎[1] 成维鹏 李莫振 

机构地区：[1]皖北煤电集团总医院SICU,安徽宿州234000

出　　处：《临床医学》2011年第11期1-3,共3页Clinical Medicine

摘　　要：目的观察无创正压通气(NPPV)及有创正压通气(IPPV)治疗光气中毒致急性呼吸窘迫综合征(ARDS)的临床疗效。方法对皖北煤电集团总医院重症监护病房收治的9例光气中毒致ARDS患者,随机分别采用NPPV及IPPV治疗,比较两组患者的呼吸机使用时间、住院时间、镇静剂使用及并发症发生情况。结果 9例患者均康复出院。NPPV治疗组5例患者中,平均使用呼吸机时间76.5 h,平均住院时间13.8 d,均未使用镇静剂,均未发生机械通气相关并发症。IPPV治疗组4例患者中,平均使用呼吸机时间82.5 h,平均住院时间22.2 d,均需要使用镇静剂,有2例患者出现机械通气相关并发症。NPPV治疗组患者的住院时间及并发症明显短或少于IPPV治疗组。结论对光气中毒致ARDS早期患者,选择NPPV与IPPV治疗,都是有效可行的;两者相比,NPPV具有无创性,不需要使用镇静剂,能缩短住院时间,减少并发症的发生,疗效优于IPPV。Objective To observe and compare the effects of NPPV and IPPV on acute respiratory distress syndrome（ARDS） caused by phosgene poisoning.Methods Nine cases of ARDS caused by acute phosgene poisoning in intensive care unit were treated with NPPV and IPPV respectively.Then the mechanical ventilation time,hospital stay,sedatives used and complications of the two groups were compared.Results Nine patients were recovered.The average ventilator time was 76.5 h,the average length of stay was 13.8 days in NPPV treatment group.None need to use sedatives,while no related complication of mechanical ventilation happened.The average ventilator time was 82.5 h,the average length of stay was 22.25 days in IPPV treatment group.All need to use sedation,while two patients had ventilator-associated complications.The hospitalization time and complications of patients treated with NPPV was significantly less than that of patients treated with IPPV.Conclusion For patients with acute phosgene poisoning in early ARDS,NPPV and IPPV treatment options are both effective and feasible.In comparison,NPPV is non-invasive,and does not require sedation and can shorten hospital stay,reduce complications,is more effective than IPPV.

关 键 词：光气 中毒 急性呼吸窘迫综合征 无创正压通气 有创正压通气 

分 类 号：R563.8[医药卫生—呼吸系统]