有创正压通气对特发性肺纤维化合并急性呼吸衰竭患者预后的干预研究  

Effect of invasive positive pressure ventilation on the prognosis of idiopathic pulmonary fibrosis combined with acute respiratory failure

作　　者：谭洪毅[1] 周作人[1] 曹足 杨宇琼[1] 杨伊莹 吴靓[1] 潘频华[1] 胡成平[1] 

机构地区：[1]中南大学湘雅医院呼吸与危重症学科,长沙410008

出　　处：《中华危重症医学杂志（电子版）》2015年第6期337-341,共5页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：十二五国家科技支撑计划课题(2013BAI09B09)

摘　　要：目的观察有创正压通气在治疗特发性肺纤维化(IPF)合并急性呼吸衰竭(ARF)中的作用。方法回顾分析中南大学湘雅医院呼吸重症监护室(RICU)2010年1月到2014年6月间收治的确诊IPF合并ARF患者12例,根据接受机械通气方式的不同分为无创正压通气(NPPV)组7例和有创正压通气(IPPV)组5例,比较两组患者的机械通气前的一般情况、实验室结果和机械通气治疗情况。结果 IPPV组入院时白细胞水平和Pa CO_2水平较NPPV组高(t=1.799,P=0.038;t=1.783,P<0.001),最终接受IPPV的5例患者在28 d内均死亡,而只接受NPPV的7例患者有5例在入住RICU后28 d仍存活,差异有统计学意义(P=0.028)。结论感染可能是导致IPF患者发生ARF的重要原因,IPF合并ARF患者不能从有创正压通气治疗中受益。Objective To evaluate the efficacy of invasive positive pressure ventilation（IPPV） in the treatment of idiopathic pulmonary fibrosis（IPF） combined with acute respiratory failure（ARF）. Methods Totally 12 patients with IPF combined with acute respiratory failure hospitalized in the respiratory intensive care unit（RICU） of Xiangya Hospital of Central South University were collected. They were divided into a non-invasive positive pressure ventilation（NPPV） group with 7 cases and an IPPV group with 5 cases, and general information, laboratory results, and clinical outcome were compared between the two groups. Results Compared with the NPPV group, the levels of WBC and Pa CO_2 in the IPPV group were higher than that in the NPPV group（t = 1.799, P = 0.038; t = 1.783,P〈0.001）. All the 5 patients in the IPPV group died within 28 days, while 5 of the 7 patients in the NPPV group survived over 28 days in RICU（P = 0.028）. Conclusion Infection could be one of the major causes for ARF in patients with IPF, and these patients may not benefit from IPPV.

关 键 词：有创正压通气 特发性肺纤维化 急性呼吸衰竭 

分 类 号：R563[医药卫生—呼吸系统]