无创呼吸机辅助呼吸在重症肺炎致呼吸衰竭抢救中的价值研究  

The value of ventilator-assisted breathing in respiratory failure caused by severe pneumonia in rescue

作　　者：高丽渊[1] 曹昕阳[1] 钟永红[1] 

机构地区：[1]杭州市余杭区第一人民医院呼吸内科,浙江杭州311100

出　　处：《中国急救医学》2014年第6期566-568,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨无创呼吸机辅助呼吸在重症肺炎致呼吸衰竭抢救中的应用,为重症肺炎所致的呼吸衰竭患者的治疗提供依据.方法 选取本院2012-06～2014-03收治的重症肺炎所致呼吸衰竭的患者40例进行研究,所有患者在常规肺炎治疗的基础上均采用无创呼吸机辅助呼吸进行治疗,观察患者治疗效果（包括症状、体征及胸部CT、胸片征象的缓解情况）,肺功能改善以及相关并发症的发生情况.结果 40例患者中39例经治疗后临床症状、体征及胸部CT征象显著优于治疗前,病情得到控制,其中1例因肾功能衰竭死亡,死亡率达2.5％;39例患者PaO2/FiO2显著优于治疗前（P＜0.05）;且患者治疗后肺功能（FVE、FEV1、PEFR）改善效果显著（P＜0.05）.结论 呼吸机辅助呼吸能够有效地促进症状和体征的恢复,减少靶器官并发症的发生,是重症肺炎致呼吸衰竭行之有效的救治方式.Objective To study the value of ventilator-assisted breathing in respiratory failure caused by severe pneumonia in rescue.It could provide the basis for the emergency treatment of patients with respiratory failure due to severe pneumonia.Methods 40 patients with respiratory failure caused by severe pneumonia from June 2012 to March 2014 in our hospital were to be studied.All patients on the basis of conventional treatment for pneumonia are non-invasive mechanical ventilation for treatment,the treatment effect was observed in patients （including relief of symptoms,signs and chest X-ray signs）,the incidence of lung function improvement and related complications.Results 40 patients after treatment in 39 cases of clinical symptoms,signs and chest X-ray signs of significantly better than before treatment,his condition stabilized into the ward,one patient died due to renal failure,the mortality rate was 2.5％ ; 39 patients PaO2/FiO2 was significantly better than before treatment,the difference was statistically significant（P ＜0.05） ; and lung function in patients after treatment （FVE,FEV1,PEFR） are significantly improved,compared with before treatment,the difference was statistically significant （P ＜ 0.05）.Conclusion Ventilator-assisted breathing can effectively promote the symptoms and signs of recovery,reduce the incidence of target organ complications,respiratory failure caused by severe pneumonia is an effective emergency treatment approach.

关 键 词：重症肺炎 呼吸衰竭 呼吸机 

分 类 号：R473.5[医药卫生—护理学]