经鼻(面)罩通气治疗急性呼吸窘迫综合征  

Nasal or oranasal face mask mechanical ventilation in the treatment of acute respiratory distress syndrome

作　　者：朱蕾[1] 钮善福[1] 李善群[1] 方智野[1] 李燕芹[1] 

机构地区：[1]上海医科大学呼吸疾病研究所中山医院肺科,200032

出　　处：《中华结核和呼吸杂志》2000年第4期225-227,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的评价经鼻（面）罩机械通气治疗急性呼吸窘迫综合征（ABDS）的疗效。方法16例ARDS患者分为感染组（7例）和非感染组（9例），前者呼吸频率（RR）（46±5）次／分，动脉血pH、二氧化碳分压（PaCO2）、氧合指数（OI）分别为7．49±0．05、（32±4）mmHg、（144±23）mmHg；后者为（41±6）次／分、7．49±0．13、（32±5）mmHg、（156±51）mmHg，经鼻（面）罩选择压力支持通气（PSV）＋呼气末正压（PEEP）。结果通气2－8h，与通气前比较感染组RR为（45±7）次／分，P＞0．05，OI升至（195±30）mmHg，P＜0．05；非感染组相应为（35±4）次／分和（228±90）mmHg（P＜0．05）。10例治愈，治愈率分别有29％（2／7）和89％（8／9）。结论　经鼻罩机械通气可作为治疗非感染性因素诱发的ARDS　的首选通气方式，而在感染患者应及早建立人工气道。] Objective To Evaluae the effect of nasal or oranasal face mask mechanical ventilation (FMMV) in the treatment of patients with acute respiratoy distress syndrome (ARDS). Methods 16 ARDS patients were separated into two groups: infection group and non-infection group.The former had 6 cases with pneumonia and 1 case with sepsis; the later had 5 cases with multiple fracture, 2 with operation of intestines obstruction, 1 with operation of spleen rupture,1 with hepatectomy. In infection group, the respiratory rate(RR) was (46±5) times/min, the arterial blood pH 7.49±0.05, CO2 partial pressure(PaCO2) was (32 ±4) mm Hg,and oxygenation index(OI) (144 ±23) mm Hg.In non-infection grouP, the RR, pH, PaCO2, OI was (41±6)times/min, 7.49±13, (32±5) mm Hg, (156±51) mm Hg. All patients were linked with ventilator via nasal or oranasal mask.Pressure support ventilation (PSV) and positive end-expiratory pressure (PEEP) were selected.Results All patients successfully received FMMV. In infection group, RR and OI returned to (45±7) times/min (P>0．05) and (195±30) mm Hg(P < 0.05) respectively after 2~8 hours via FMMV. But in non-infection group,the RR and OI were (35±4) times/min(P < 0.05) and (228±90)mm Hg(P<0.05). 2 cases(29%)in infection group and 8 cases(89% ) in non-infection were successfully weaned from FMMV. Conclusion FMMV could be as the first choice in ARDS patients without infection, and airway intubation should be given in infectious patients as early as possible.

关 键 词：急性 呼吸窘迫综合征 机械通气 鼻罩 

分 类 号：R563.8[医药卫生—呼吸系统]