以BiPAP模式的呼吸支持促进危重创伤病人彻底复苏—附50例临床分析  

To promote the thorough resuscitation of severely injured patients by using BiPAP respirator-a clinical analyses of 50 cases

作　　者：白嘉祥[1] 

机构地区：[1]天津医院ICU,300211

出　　处：《实用心脑肺血管病杂志》2000年第2期92-94,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的 尽快纠正危重创伤病人早期低氧血症,避免病情进一步恶化。减少并发症,提高治愈率。方法 50例危重创伤病人随机分为二组,其中21例应用BiPAP呼吸机,29例用鼻导管供氧,二组病人入病房后即刻进行血气分析,治疗二天后复查血气,然后对二组PaO_2及氧合指数结果分别予以对比。结果 BiPAP组治疗后PaO_2从平均9.3kPa上升至13kPa,氧合指数从平均224上升至303(P<0.01),而对照组治疗前PaO_2平均11.3,治疗后为11.4,氧合指数治疗前平均为288,治疗后平均为277,无显著性差异(P>0.05)。结论 对危重创伤病人早期的低氧血症给予机械辅助通气1～3天。进行超量供氧。能有效地恢复生理性氧供、偿清氧债。为危重创伤病人初期复苏成功后的一项有力措施。并较单纯经鼻导管供氧明显优越。Objective To correct the early hypoxemia of severely injured patient, prevent the condition to be worsened, and reduce the complication. Methods The 50 cases of severely injured patients were randomly devided into 2 groups. The BiPAP respirator group included 21 cases,the nose-cannula group 29 cases. Each patient from both groups was examined blood-gas immediately following admission, and re-examined 2 therapeutic days later. The PaO2 value and oxygenated index of the two groups were contrasted. Results The average PaO2 and oxygenated index of BiPAP group increased from 9. 3kPa,224 to 13kPa,303,after com- pared with each other both were very significant (P < 0. 01). Whereas the average PaO2 and oxygenated index of the control group were 11. 3kPa, 288 and 11. 4kPa, 277, after therapy both were insignificant (P>0. 05). Conclusion 1 - 3 days of mechanical assistant ventilation should be given to severely injured patients who suffered early hypoxemia. The excessive oxygen supply could effetively restore the insufficient physiologic orygen and reimburse orygen debt. It is a powerful procedure for the severely injured patients in the initial resuscitation,and obviously superior to the nose-cannula route.

关 键 词：BIPAP 低氧血症 危重创伤 呼吸支持 复苏 

分 类 号：R605.974[医药卫生—急诊医学]