面罩通气治疗肝性脑病的疗效观察  

THERAPIC EFFECT OF MASK VENTILATION ON HEPATIC ENCEPHALOPATHY

作　　者：郭永高[1] 吴明波[1] 周甜[1] 张双双[1] 庞淑兰 

机构地区：[1]江苏省徐州市中心医院,221009 [2]华北理工大学公共卫生学院

出　　处：《中国煤炭工业医学杂志》2015年第11期1799-1801,共3页Chinese Journal of Coal Industry Medicine

基　　金：河北省科技支撑计划项目(编号:11276104D)

摘　　要：目的观察面罩通气治疗肝性脑病的疗效。方法回顾性分析2011年1月—2014年12月在徐州市中心医院治疗的60例肝性脑病患者的临床资料,其中28例为鼻导管吸氧,32例给予面罩通气,比较二组患者治疗前后血氨水平、动脉血二氧化碳分压(PaCO2)。结果二组患者的年龄、性别、肝功能分级和肝硬化病因差异均无统计学意义(P>0.05)。治疗前鼻导管给氧组肝性脑病平均分级为2.86±0.87,面罩通气组平均分级为3.13±0.72,二组比较差异无统计学意义(t=0.927,P=0.362)。经过48h治疗后,面罩通气组治疗后肝性脑病分级显著低于鼻导管给氧组,1.69±0.60vs.2.43±1.02,二组比较差异有统计学意义(t=2.386,P=0.027);面罩通气组血氨下降程度显著高于鼻导管给氧组(t=-3.385,P=0.002);面罩通气组PaCO2水平显著高于鼻导管给氧组,38.7±5.0vs.27.6±6.3,(t=-5.363,P<0.001)。结论面罩通气能够纠正肝性脑病患者的低二氧化碳血症,从而有助于肝性脑病的治疗。Objective To observe the treating effect of mask ventilation on hepatic encephalopathy.Methods A retrospective analysis of clinical data of 60 patients with hepatic encephalopathy treated in Xuzhou Central Hospital from January2011 to December 2014 was performed,including28 cases with nasal cannula oxygen and 32 with mask ventilation.Blood ammonia levels and arterial carbon dioxide tension（PaCO2）before and after treatment were compared.Results The patients＇ age,sex,cause of cirrhosis and liver function were not significantly different between the two groups（P〉0.05）.Hepatic encephalopathy score before treatment was 2.86 ± 0.87 vs.3.13 ± 0.72 in the nasal cannula oxygen group and mask ventilation group,respectively,the difference was not statistically significant（t=0.927,P=0.362）.After 48 h treatment,hepatic encephalopathy score in the mask ventilation group was significantly lower than that in the nasal cannula oxygen group（1.69±0.60 vs.2.43±1.02）,the difference was statistically significant（t=2.386,P=0.027）;the decrease of blood ammonia in the mask ventilation group was significantly high compared with the nasal cannula oxygen group（t=-3.385,P=0.002）;PaCO2of mask ventilation group was significantly higher than the nasal oxygen catheter group（38.7±5.0vs.27.6±6.3）,t=-5.363,P 〈0.001.Conclusion The mask ventilation can correct hypocapnia in patients with hepatic encephalopathy,and it is conductive to the treatment of hepatic encephalopathy.

关 键 词：肝性脑病 面罩通气 血氨 动脉血二氧化碳分压 

分 类 号：R575.2[医药卫生—消化系统]