气管插管并人工机械通气抢救严重急性呼吸衰竭患者临床分析  

Endotracheal intubation and artificial mechanical ventilation to rescue patients with severe acute respiratory failure clinical analysis

作　　者：华文良[1] 汤超[1] 汤文夏 

机构地区：[1]江苏省太仓市第一人民医院急诊科,江苏太仓215400

出　　处：《中国现代医生》2014年第32期158-160,共3页China Modern Doctor

基　　金：江苏省太仓市科技发展计划(TC2013Z005)

摘　　要：目的探讨严重急性呼吸衰竭患者采取早期气管插管并人工机械通气抢救治疗的临床效果。方法将我院2012年1月～2014年6月接诊的严重急性呼吸衰竭患者40例作为研究对象，回顾性分析其临床资料，皆符合机械通气指征，予以早期气管插管并人工机械通气抢救治疗，观察记录治疗前后血压、血氧饱和度（SaO2）、呼吸、氧分压（PaO2）、二氧化碳分压（PaCO2）、pH值等指标情况，并进行对比分析，同时记录抢救成功率、通气时间及并发症等情况。结果经过抢救治疗后，患者的呼吸频率、血压、二氧化碳氧分压有明显降低，相较于治疗前差异有统计学意义（P〈0．05或P〈0．01），而血氧饱和度、pH值、氧分压则有明显升高，相较于治疗前差异有统计学意义（P〈0．01）。40例患者最终顺利脱机拔管并治疗成功38例，死亡2例，抢救成功率95．00％；发生并发症3例，发生率为7．50％。结论针对各种原因所致严重急性呼吸衰竭患者，及时予以早期气管插管并人工机械通气抢救治疗可以取得比较良好的抢救成功率，同时能明显改善患者的呼吸频率、血压、氧分压、二氧化碳分压、pH值等指标，并且并发症较少，值得借鉴。Objective To study the patients with severe acute respiratory failure to adopt early endotracheal intubation and the clinical effect of artificial mechanical ventilation rescue treatment. Methods From January 2012 to June 2014, selected 40 patients with severe acute respiratory failure as the research objects, their clinical data were retrospectively analyzed, all were comformed to the indication of mechanical ventilation, the patients were received early endotracheal intubation and rescue of artificial mechanical ventilation therapy, observed records blood pressure, blood oxygen satura tion （SaO2）, breathing, oxygen partial pressure （PaO2）, CO2 partial pressure （PaCO2）, pH indicators before and after treat- ment, and analysis, at the same time recorded the rescue success rate, ventilation time and complications, and so on and so forth. Results After treatment, the patients＂ breathing rate, blood pressure, carbon dioxide, oxygen partial pressure were significantly decreased, compared with before treatment was statistically significant difference （P〈0.05 or P〈0.01）, and blood oxygen saturation, pH value, oxygen partial pressure had increased significantly, compared with before treat ment was statistically significant difference （P〈0.01）. 40 patients eventually offiine pull off smoothly and successfully treated 38 cases, 2 cases died, the rescue success rate of 95.00%; The incidence of complications in 3 patients, was 7.50%. Conclusion For patients with severe acute respiratory failure caused by various reasons, in early endotracheal intubation and rescue of artificial mechanical ventilation therapy can get good rescue success rate, at the same time can obviously improve the patients＂ breathing rate, blood pressure, oxygen partial pressure, CO2 partial pressure, pH value and other indicators, and fewer complications, is worth using for reference.

关 键 词：严重急性呼吸衰竭 气管插管 人工机械通气 抢救 

分 类 号：R563.8[医药卫生—呼吸系统]