早期机械通气在治疗脑干出血并发呼吸衰竭中的应用  

The Application of Early Stage Mechanical Ventilation in the Treatment of Brainstem Hemorrhage Complicated with Respiratory Failure

作　　者：龙海波 俞方毅 梁绍华 袁丹丹 伍海桥 朱斯彧 LONG Haibo;YU Fangyi;LIANG Shaohua;YUAN Dandan;WU Haiqiao;ZHU Siyu(Guangzhou Red Cross Hospital,Guangzhou 510220,China)

机构地区：[1]广州市红十字会医院,广东广州510220

出　　处：《现代医院》2018年第7期1022-1023,1030,共3页Modern Hospitals

基　　金：广东省自然科学基金项目(编号:10151022001000005);广州市医药卫生科技项目(编号:2015A01002)

摘　　要：目的探讨机械通气治疗脑干出血并发呼吸衰竭的临床应用效果及安全性。方法将60例脑干出血并发呼吸衰竭病人随机分为治疗组和对照组。治疗组采用早期通气治疗,对照组则采用常规机械通气,比较治疗前后血气分析结果、治疗后的疗效及医院获得性肺炎的发生情况。结果治疗组和对照组的血气分析指标水平均优于治疗前,而治疗组的血气分析指标PaO_2(13.31±0.81)k Pa、PaCO_2(4.01±0.65)k Pa、SaO_2(97.79±1.01)%显著优于对照组,差异具有统计学意义(P<0.05);治疗组总有效率83.33%,高于对照组的46.66%,差异具有统计学意义(P<0.05);治疗组院内获得性肺炎发生率为16.67%,低于对照组的43.33%,差异具有统计学意义(P<0.05)。结论早期机械通气治疗脑干出血并发呼吸衰竭,病人的血气纠正时间快、脑缺氧情况恢复较快,是较有效而且安全的急诊处理方法。Objective To explore the clinic effect and safety of early stage mechanical ventilation in the treatment of brainstem hemorrhage complicated with respiratory failure. Methods 60 cases of patients with brainstem hemorrhage complicated with respiratory failure were randomly divided into the treatment group and the control group. The treatment group was treated with early mechanical ventilation,while the control group was treated with conventional mechanical ventilation. The blood gas analysis indices before and after treatment and the therapeutic effect after treatment,as well as the incidences of hospital acquired pneumonia were compared between the two groups. Results The blood gas analysis indices of the treatment group and the control group were all better than those before treatment. The indices of blood gas analysis in the treatment group： Pa O2（ 13. 31 ± 0. 81） k Pa,Pa CO2（ 4. 01 ± 0. 65） k Pa,Sa O2（ 97. 79 ± 1. 01） %,were significantly better than those in the control group,with statistically significant difference（ P〈0. 05）. The total effective rate of the treatment group was83. 33%,which was higher than the 46. 66% of the control group,with statistically significant difference（ P〈0. 05）. The incidence of hospital acquired pneumonia in the treatment group was 16. 67%,which was lower than the 43. 33% of the control group,with statistically significant difference（ P〈0. 05）. Conclusion Early stage mechanical ventilation is an effective and safe method for emergency treatment for the brainstem hemorrhage complicated with respiratory failure,for it can rectify the blood gas and recover normal oxygen supply to cerebrum in short time.

关 键 词：机械通气 脑干出血 呼吸衰竭 

分 类 号：R589.3[医药卫生—内分泌]