无创正压通气在急性呼吸衰竭急救中的回顾性研究  

Retrospective investigation of non-invasive positive pressure ventilation in emergency treatment for patients with respiratory failure

作　　者：谢美芳[1] 崔娜[1] 王光苏[1] 

机构地区：[1]江苏省第二中医院急诊科,南京210017

出　　处：《临床急诊杂志》2014年第2期92-94,共3页Journal of Clinical Emergency

摘　　要：目的:评价无创正压通气(NIPPV)在抢救急性呼吸衰竭患者中的疗效。方法:对入选的38例急性呼吸衰竭患者使用无创正压呼吸机辅助通气,动态观察治疗前和治疗后2h动脉血气及生命体征变化。结果:38例患者中23例经NIPPV治疗2h后,PaO2明显升高(P<0.01),PaCO2明显降低(P<0.01),pH升高(P<0.05),有效率达63.2%(23/38)。对病因为AECOPD、间质性肺炎、急性左心衰及肺部感染的患者,疗效显著;而对病因为支气管哮喘、肺癌、ARDS及MOF患者疗效差。其中Ⅰ型呼衰成功率40.0%(6/15),Ⅱ型呼衰成功率78.5%(18/23),NIPPV对Ⅱ型呼衰救治成功率明显高于Ⅰ型呼衰(P<0.01)。结论:NIPPV在急性呼吸衰竭急救中疗效确切,应用时应掌握指征以提高疗效。Objective：To evaluate the value of non-invasive positive pressure ventilation（NIPPV） in the treat ment of respiratory failure. Method：Thirty-eight patients with acute respiratory failure received assisted ventilation via face mask by bi level non-invasive positive ventilator. The chang e of arterial blood gas, conscious state, outcome and complications of NIPPV were investigated. Result： NIPPV increased PaO2 significantly （P〉 0. 01 ）, declined PaCO2 significantly（P〈0.01）, elevated blood pH （P〈0.05） in twenty-three patients. The efficacy of causes of respiratory failure with acute exacerbation of chronic obstructive pulmonary disease, interstitial pneumonia, acute left ventricular failure and lung infection were significantly. But the efficacy of causes of respiratory failure with bronchial asthma, lung cancer, adult respiratory distress syndrome and multiple organ failure were not significant ly. The success rate of type I respiratory failure is 40 %（6/15） ; The success rate of type II respiratory failure is 78. 5 % （18/23）. NIPPV is more successful for type II respiratory failure patients than for type I （P〈 0.01 ）. Conclu- sion：NIPPV is effective for the patients with respiratory failure. We should master the points to improve the clinical efficacy.

关 键 词：无创正压通气 呼吸衰竭 急救 

分 类 号：R563.8[医药卫生—呼吸系统]