无创通气抢救海洛因中毒所致急性呼吸衰竭的疗效观察  

Application of non-invasive ventilation in treatment of acute respiratory failure caused by heroin intoxication during pre-hospital medical service

作　　者：严浩[1] 李贝[1] 

机构地区：[1]北京急救中心中心站,北京100031

出　　处：《中国急救复苏与灾害医学杂志》2016年第1期20-22,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的 探讨应用双水平气道正压（BiPAP）无创呼吸机辅助通气，在院外抢救海洛因中毒所致急性呼吸衰竭中的使用价值。方法选取北京急救中心2011年1月一2013年1月，院外抢救重症海洛因中毒所致急性呼吸衰竭患者60例，将其随机分为治疗组和对照组。对照组采用鼻导管吸氧＋纳洛酮常规治疗，病情危重时行气管插管。治疗组在对照组的基础上加用BiPAP无创呼吸机辅助通气治疗，观察两组患者的临床疗效。结果两组患者治疗后临床疗效相比较：治疗2h后血气改善，治疗组优于对照组，但差异无统计学意义（P〉0．05）。治疗组在治愈率，气管插管数，总治疗时间上均优于对照组，差异有统计学意义（P〈0．005）。结论在院外抢救海洛因中毒所致急性呼吸衰竭中加用BiPAP无创呼吸机辅助通气，疗效确切，副作用少，值得推广。Objective To discuss the clinical value of using Bi-PAP non-invasive ventilator in rescuing acute respiratory failure caused by heroin intoxication in pre-hospital stage. Methods Sixty patients acute respiratory failure caused by heroin intoxication, aged （31.4±4.5） （ 21- 48）, were randomly divided into 2 grouos： treatment group （n=31） and control group （n=29）. Traditional treatment with nasal tube oxygen and naloxone was delivered to 29 patients （control group）. Bilevel Positive Airway Pressure （BI-PAP） non-invasive ventilator was used plus tl：aditional treatment on 31 patients （BI-PAP group）. Tracheal intubation was given to critical patients. The prognosis was observed. Two hours after treatment blood gas analysis was conducted. Results Two hours after treatment there were not significant differences in the pH, PCO2 , and PO2 between these 2 groups （all P 〉0.05）. The general treatment time of the treatment group was （2.7±1.2） h, significantluy shorter than that of the control group [（4.1 ± 1.6）h, P 〈 0.05]. The effective rate of the Bi-PAP group was 100.0%, significantly higher than that of the control group （93.1%, P 〈 0.05）. Invasive ventilation was needed by 4 patients in the control group, however, none in the BiPAP group needed it. Conclusion Non-invasive ventilation is effctive in treatment of acute respiratory failure caused by heroin intoxication during the pre-hospital medical service stage.

关 键 词：海洛因中毒 无创通气 呼吸衰竭 

分 类 号：R605[医药卫生—外科学] R595.4[医药卫生—临床医学]