重症肺炎呼吸衰竭患者使用无创呼吸机的通气状况及其改善效果  

Improving effect of non-invasive ventilation on ventilation condition and clinical symptoms in patients with respiratory failure caused by severe pneumonia

作　　者：谢环英[1] 陈海英[2] 张建忠[3] 张印军 孙宏娟[1] 

机构地区：[1]武警北京总队第三医院急诊科,100141 [2]武警北京总队第三医院医务处,100141 [3]武警北京总队第三医院肿瘤科,100141 [4]武警北京总队第三医院门诊部,100141

出　　处：《武警医学》2015年第12期1245-1247,1252,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨无创呼吸机对重症肺炎所致呼吸衰竭患者通气状况及临床症状的改善效果。方法 50例重症肺炎致呼吸衰竭患者随机分为观察组和对照组,各25例,观察组采用无创正压通气,对照组给予鼻导管吸氧,比较两组通气状况指标、心功能指标、血清炎性介质含量。结果观察组动脉血氧分压（PaO_2）（82.32±9.34）mm Hg和动脉血氧饱和度（SaO2）（95.52±9.19）%明显高于对照组的（70.29±7.78）mm Hg和（90.01±9.04）%,动脉血二氧化碳分压（PaCO_2）明显低于对照组（t为2.150~6.161,P均〈0.05）;心功能指标：观察组呼吸频率（RR）、心率（HR）、左心室舒张末期直径（LVEDD）均明显低于对照组,射血分数（LVEF）明显高于对照组（t为3.284~5.022,P均〈0.05）;炎性介质含量：观察组血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）含量低于对照组（t为11.928~19.9444,P均〈0.05）。结论无创正压通气能够改善通气状况及临床症状,缓解炎症反应。Objective To study the improving effect of non-invasive ventilation on ventilation condition and clinical symptoms in patients with respiratory failure caused by severe pneumonia. Methods 50 patients with respiratory failure caused by severe pneumonia in this hospital were randomly divided into study group and control group. Study group received noninvasive positive pressure ventilation,whereas control group received nasal oxygen catheterization. Then,ventilation condition,cardiac function index,serum inflammatory mediators amd adverse reactions were compared between the two groups. Results Ventilation index： in the study group Pa O2（ 82. 32 ± 9. 34） mm Hg,Sa O2（ 95. 52 ± 9. 19） % was significantly higher than in the control group,（ 70. 29 ± 7. 78） mm Hg,Sa O2（ 90. 01 ± 9. 04） %; Pa CO2 was significantly lower than in the control group（ t = 2. 150- 6. 161,P〈0. 05）. Cardiac function index：in the study group RR,HR,LVEDD were significantly lower than in the control group,LVEF was significantly higher than in the control group（ t = 3. 284- 5. 022,P〈0. 05）. Inflammation medium content： in the study group,TNF-α,IL-6,IL-1β were significantly lower than in the control group（ t = 11. 928- 19. 9444,P〈0. 05）. Adverse reactions： in the study group adverse reactions rate was40. 00%,significantly lower than 68. 00% in the control group. Conclusions Noninvasive positive pressure ventilation improves ventilation condition and clinical symptoms,and relieves inflammation.

关 键 词：重症肺炎 呼吸衰竭 无创正压通气 炎性介质 

分 类 号：R563.1[医药卫生—呼吸系统]