肺癌术后呼吸衰竭患者使用无创正压辅助通气治疗的疗效评价  

Evaluation of the therapeutic efficiency of assisted ventilation of non-invasive positive pressure for patients with post operative respiratory failure of lung carcinoma

作　　者：刘星[1] 朱江[1] 李丽[2] LIU Xing;ZHU Jiang;LI Li(Intensive Care Unit,Dujiangyan People＇s Hospital,Dujiangyan 611830,China.)

机构地区：[1]都江堰市人民医院ICU,四川都江堰611830 [2]都江堰市人民医院呼吸科,四川都江堰611830

出　　处：《中国医学装备》2018年第11期78-82,共5页China Medical Equipment

摘　　要：目的:观察肺癌术后呼吸衰竭患者使用呼吸机辅助通气治疗效果。方法:选取194例肺癌术后呼吸衰竭患者,按照随机数表法将其纳入观察组与对照组,每组97例。对照组采用常规呼吸衰竭干预,观察组采用呼吸机无创正压辅助通气,比较两组患者治疗前、治疗3 h、12 h、24 h和48 h后血气分析指标[动脉氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)]、氧代谢指标[中心静脉血氧饱和度(SevO_2)、混合静脉血氧分压(PvO_2)]和肺功能指标[最大通气量/min(MVV)、最大呼气中期流速(MMF)、最大呼气压(PE)]水平。结果:两组患者治疗后3 h、12 h、24 h和48 h,观察组血气分析PaO_2水平均优于对照组,差异有统计学意义(t=3.394,t=3.400,t=3.420,t=3.284;P<0.05);观察组血气分析PaCO_2水平均优于对照组,其差异有统计学意义(t=3.597,t=3.102,t=3.284,t=3.114;P<0.05);观察组的氧代谢SevO_2水平指标优于对照组,其差异有统计学意义(t=3.940,t=3.704,t=3.500,t=3.306;P<0.05);观察组肺功能MVV水平指标改善优于对照组,其差异有统计学意义(t=3.394,t=3.400,t=3.420,t=3.284;P<0.05)。观察组无病死病例,两组病死率比较差异有统计学意义(x^2=4.000,P<0.05)。结论:呼吸机辅助通气能显著改善肺癌术后呼吸衰竭患者肺功能、纠正低氧状态且作用迅速,有助于降低病死率改善预后。Objective： To observed the therapeutic effect of ventilator-assisted ventilation for patients with postoperative respiratory failure of lung carcinoma. Methods： 194 patients with postoperative respiratory failure of lung carcinoma were divided into the observation group （97 cases） and control group （97 cases） according to the random number table method. The control group adopted routine intervention for respiratory failure and the observation group adopted assisted ventilation of non-invasive positive pressure. The blood gas analysis indicators[Arterial oxygen partial pressure（PaO2）, arterial carbon dioxide partial pressure（PaCO2）], oxygen metabolism indexes [Central venous blood oxygen saturation（SevO2）, mixed venous blood oxygen partial pressure（PvO2）], lung function indexes [（maximal voluntary ventilation/min（MVV）, maximal mid-expiratory flow （MMF）, maximal expiratory pressure （PE）] at pre-operation, 3h, 12h, 24h and 48h post treatment between the two groups were compared. Results： At 3h, 12h, 24h and 48h post treatment, the blood gas analysis of PaO2 of observation group were significantly better than those of control group （t=3.394, t=3.400, t=3.420, t=3.284, P〈0.05）, and those of PaCO2 of observation group also were significantly better than those of control group （t=3.597, t=3.102, t=3.284, t=3.114, P〈0.05）. And the SevO2 levels of blood oxygen metabolism of observation group was significantly better than those of control group （t=3.940, t=3.704, t=3.500, t=3.306, P〈0.05）. And the MVV levels of lung function of observation group were significantly better than those of control group （t=3.394, t=3.400, t=3.420, t=3.284, P〈0.05）. Besides, there was no case of death in observation, and the difference of mortality between the two groups was significant （x2=4.000, P〈0.05）. Conclusion： Ventilator-assisted ventilation can significantly improve lung function of patients with postoperative respiratory failure of lung carcinoma, and can cor

关 键 词：肺癌 术后 呼吸衰竭 呼吸机 无创正压辅助通气 

分 类 号：R734.2[医药卫生—肿瘤] R563.8[医药卫生—临床医学]