有创与无创正压通气治疗重症社区获得性肺炎合并呼吸衰竭临床疗效观察  

Observation on the Effects of Invasive and Noninvasive Positive Airway Pressure on SCAP Combined with Respiratory Failure

作　　者：林鸣[1] 庞胜[1] 詹述德 

机构地区：[1]四川省资中县人民医院,四川资中641200

出　　处：《河北医学》2014年第3期468-471,共4页Hebei Medicine

摘　　要：目的:比较有创与无创正压通气治疗重症社区获得性肺炎(SCAP)合并呼吸衰竭患者的临床效果,寻找最佳治疗措施。方法:选取符合标准的患者60例,随机分为观察组和对照组各30例,均给予常规治疗,观察组加用无创正压通气,对照组加用有创正压通气,比较临床治疗效果。结果:两组患者治疗前呼吸、心率、PaO2、PaCO2、PaO2/PiO2及PH等各项指标比较,差异无统计学意义(P>0.05);治疗后30min、24h各项指标均明显好转,较同组治疗前比较,差异有统计学意义(P<0.05);两组患者治疗后30min、24h各项指标比较,差异无显著性(P>0.05)。两组患者在呼吸机辅助呼吸时间、生存率及住院时间等方面比较,差异无统计学意义(P>0.05)。结论:无创正压通气治疗SCAP伴急性呼吸衰竭可以明显改善患者的病情,减少有创通气使用率,值得临床推广应用。Objective：To compare the clinical effects of invasive vs .noninvasive positive airway pres-sure on severe community acquired pneumonia （ SCAP ） combined with respiratory failure , and to find out the best therapeutic measures .Method：60 patients meeting the criteria were selected and randomly divided into observation group and control group , 30 patients in each group .Both groups were given with convention-al therapy, and the observation group was supplemented with noninvasive positive airway pressure , while the control group supplemented with invasive positive airway pressure , and the clinical therapeutic effects were compared.Result：The differences in pre-therapeutic breath, heart rate, PaO2, PaCO2, PaO2/PiO2 and PH and so on were statistically insignificant （P＆gt;0.05）;30min and 24 hours after treatments, all the above inde-xes were significantly improved , and when compared with those of the same group before the treatment , the differences were statistically significant （P＆lt;0.05）;30min and 24 hours after treatments, the differences of the above indexes between the two groups were statistically insignificant （P＆gt;0.05）.The differences in time of respiration assisted by a breathing machine , survival rate and length of stay in hospital and so on were sta-tistically insignificant （ P＆gt;0.05） .Conclusion：Noninvasive positive airway pressure in treatment of SCAP ac-companied by respiratory failure can significantly improve the pathogenetic conditions of the patients , de-crease the use frequency of invasive ventilation , and consequently is worthy of clinical application .

关 键 词：重症社区获得性肺炎 急性呼吸衰竭 有创正压通气 无创正压通气 

分 类 号：R563.1[医药卫生—呼吸系统]