有创-无创序贯通气疗法在治疗ARDS的有效性与安全性评价  

Invasive-sequential Noninvasive Ventilation Therapy in the Treatment of ARDS Efficacy and Safety Evaluation

作　　者：郑权[1] 汪洪[1] 黄勤[1] 郭华[1] 代光明[1] ZHENG Quan WANG Hong HUANG Qin GUO Hua DAI Guang-ming(Department of Respiratory,First People＇s Hospital of Suining City,Sichuan Province Suinin)

机构地区：[1]四川省遂宁市第一人民医院呼吸内科

出　　处：《世界最新医学信息文摘》2017年第14期1-2,共2页World Latest Medicine Information Electronic Version

摘　　要：目的探讨有创-无创序贯通气疗法在治疗ARDS患者的有效性与安全性。方法选取2011年2月至2016年11月收治的80例ARDS患者,随机分成观察组及对照组,各40例,观察两组患者的有创通气时间、总机械通气时间、呼吸机相关肺炎(VAP)发生率和病死率。结果两组患者经过治疗后出现"ARDS控制窗"情况时,对两组患者的出现时间、平均气道压(MAP)、呼吸频率(RR)、心率(HR)、酸碱度(p H)、氧合指数(Pa O_2/Fi O_2)、二氧化碳分压(Pa CO_2)等方面进行分析,差异无统计学意义(P>0.05)。观察组患者在拔管前、无创通气12h后对呼吸频率(RR)、心率(HR)、收缩压、氧合指数(Pa O_2/Fi O_2)及酸碱度(p H)进行分析,对比分析后,差异无统计学意义(P>0.05)。两组患者经过治疗撤机后,对两组患者的临床指标进行比较,差异有统计学意义(P<0.05)。结论有创-无创序贯通气疗法对抢救ARDS有肯定的临床疗效,且可明显降低有创机械通气并发症,特别是VAP的发生率及死亡率。Objective To investigate the invasive-sequential noninvasive ventilation therapy in the treatment of ARDS efficacy and safety evaluation. Methods 88 patients with ARDS were selected from February 2011 to Novermber 2016 in our hospital, divided into observation group and control group with 40 patients respectively. Patients with invasive ventilation time, total duration of mechanical ventilation, ventilator-associated pneumonia（VAP） incidence and mortality were observed. Results After treatment, Two groups of patients appeared ＂ARDS control window＂ happened, the two groups of patients with MAP, RR, HR, p H, Pa O2/Fi O2, Pa CO2 were analyzed, the difference was not statistically significant（P〈0.05）. The patients before extubation, non-invasive ventilation after 12 h of RR, HR, systolic blood pressure, Pa O2/Fi O2 were analyzed and the difference was not statistically significant（P〈0.05）. After weaning groups of patients after treatment for invasive ventilation time, the total duration of mechanical ventilation, ICU stay, hospital costs, VAP and deaths were compared, the difference was not statistically significant（P〈0.05）. Conclusion Invasive-non-invasive ventilation therapy can salvage SAP sequential ARDS caused by clinical efficacy for sure, and can significantly reduce the complications of invasive mechanical ventilation, especially in the incidence of VAP and mortalityl.

关 键 词：有创-无创序贯通气 急性呼吸窘迫综合征 疗效 

分 类 号：R563.8[医药卫生—呼吸系统]