无创双水平正压呼吸机与有创呼吸机治疗87例呼吸衰竭患儿的疗效观察及护理干预  

Curative effect observation and nursing intervention of 87 cases of children with respiratory failure treated by noninvasive bi level positive pressure respirator and invasive mechanical ventilation

作　　者：韩海玲 赵枫[2] 

机构地区：[1]咸阳市中心医院,陕西咸阳712000 [2]延安大学附属医院儿科,陕西延安716000

出　　处：《临床医学研究与实践》2016年第17期182-184,共3页Clinical Research and Practice

摘　　要：目的 探讨无创双水平正压呼吸机与有创呼吸机治疗呼吸衰竭患儿的临床疗效及护理干预方法。方法 选择我院2013年4月至2016年4月收治的87例呼吸衰竭患儿随机分为治疗组（n=44）和对照组（n=43）。两组均进行通畅气道、解痉平喘、抗感染等常规基础治疗,对照组采用有创呼吸机辅助治疗,治疗组给予无创双水平正压呼吸机辅助治疗。观察两组患儿治疗后心率（HR）、呼吸频率（RR）、p H值、血氧分压（Pa O2）、动脉血二氧化碳分压（Pa CO2）、氧合指数,并统计通气时间、住院时间、并发症发生率和拔管成功率。结果 治疗组患儿HR、RR、Pa CO2均低于对照组（P〈0.05）,Pa O2和氧合指数则高于对照组（P〈0.05）。与对照组比较,治疗组通气时间、住院时间均显著降低（P〈0.01）。治疗组并发症发生率显著低于对照组（x^2=5.286,P〈0.05）,拔管成功率显著高于对照组（x^2=4.145,P〈0.05）。结论 无创双水平正压呼吸机治疗呼吸衰竭患儿临床疗效显著,可以使HR、RR、Pa CO2有效降低,Pa O2和氧合指数有效升高;住院时间短,并发症发生率低,可以有效改善患者生活质量。另外,需给予综合性护理干预措施,以达到人机协调,提高患儿预后效果。Objective This study aims to explore the clinical efficacy and nursing intervention of noninvasive bi level positive pressure ventilator and invasive respirator in the treatment of children with respiratory failure. Methods Eighty- seven patients admitted to our hospital from April 2013 to April 2016 were randomly divided into treatment group （n=44） and control group （n=43）. All the patients were treated by routine therapy, including airway patency, anti-spasmodic, anti- infection and so on. While the control group was treated with invasive mechanical ventilation therapy, and the treatment group was treated with noninvasive bi level positive pressure ventilation. The heart rate （HR）, respiratory rate （RR）, pH value, partial pressure of oxygen （Pa02）, arterial partial pressure of carbon dioxide （PaCO2）, oxygenation index, and recorded the ventilation time, hospitalization time, and also the rate of complications occurrence and extubation success rate were observed. Results The level of HR, RR, PaCO2 of the patients in the treatment group were lower than those of the control group, the difference were statistically significant （P〈0.05）; the level of PaO2 and oxygenation index were higher than those of the control group, the difference were statistically significant （P〈0.05）. The ventilation time and the hospitalization time in treatment group were significantly lower than those of the control group, the difference were statistically significant （P〈 0.05）. The complication rate in the treatment group was significantly lower than the control group （x^2=5.286, P〈0.05）, and the rate of extuhation success in the treatment group was significantly higher than that of the control group （x^=4.145, P〈 0.05）. Conclusion Noninvasive hi level positive pressure ventilation in the treatment of respiratory failure in the children is more effective. It can significantly decrease the level of HR, RR, PaCO2, and increase the level of PaO2, oxygenation index of children. It can als

关 键 词：无创双水平正压呼吸机 有创呼吸机 呼吸衰竭 患儿 气道通畅 

分 类 号：R473.5[医药卫生—护理学]