无创正压机械通气治疗急性呼吸衰竭临床治疗效果分析  

Clinical efficacy of noninvasive positive pressure ventilation in the treatment of acute respiratory failure

作　　者：韩磊[1] 叶丹[1] 魏庆忠[1] 李海渝[1] 卜丽[1] 臧桂琴 金午仙 Han Lei;Ye Dan;Wei Qingzhong(Beijing Aerospace General Hospital,Beijing 100076)

机构地区：[1]北京航天总医院急诊科,100076

出　　处：《中国现代医药杂志》2017年第7期36-39,共4页Modern Medicine Journal of China

摘　　要：目的初步探讨急诊无创性机械正压通气治疗急性呼吸衰竭的临床效果。方法将急性呼吸衰竭患者66例,其中急性左心功能衰竭30例,慢性阻塞性肺疾病(COPD)急性加重期36例,随机分为治疗组和对照组,各33例。对照组采用急诊常规治疗,治疗组在此基础上加用无创正压机械通气治疗。比较2组有效率、病死率。同时左心衰组和COPD组组内比较B型利钠肽(BNP)、心率(HR)、呼吸频率(RR)、氧分压(PaO_2)、二氧化碳分压(PaCO_2)和小鼠pH值水平。结果治疗组的病死率明显低于对照组,有效率明显高于对照组,两组差异均有统计学意义(P<0.05)。COPD加重期的治疗组在治疗2h、24h后心率、呼吸频率、二氧化碳分压降低,氧分压及pH值升高,并且治疗后心率、呼吸频率、氧分压、二氧化碳分压及pH改善程度明显优于对照组,差异均有统计学意义(P<0.05)。结论急诊无创机械正压通气对于各种急性呼吸衰竭的治疗效果显著,降低了病死率,可以明显改善患者的临床症状。Objective To discuss the clinical effect of emergency noninvasive positive pressure ventilation in treatment of acute respiratory failure.Methods66acute respiratory failure patients(30cases were acute left heart failure,36cases were acute esacerbation of chronic obstructive pulmonary disease)were randomly divided into treatment group and control group,each of33cases.Control group received conventional care.On the basis of control group,treatment group received noninvasive positive pressure ventilation.Compared the efficiency,the incidence of complication,mortality.Acute left heart failure group and COPD group compared brain natriuretic peptide(BNP),heart rate(HR),respiratory frequency(RR),oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2)and pH.Results The efficiency of treatment group was higher than control group,the mortality was lower than control group,there were significant differences(P<0.05).After therapy2h,24h,HR,RR,PaCO2of treatment group lowed,the degree of improvement of PaO2and pH increased,the HR,RR,PaO2,PaCO2and pH were better than those of control group,the difference were statistically significant(P<0.05).Conclusion Emergency noninvasive positive pressure ventilation has significant effect on acute respiratory failure,it can significantly reduce morbidity and mortality and improve life quality.

关 键 词：急诊 无创性机械正压通气 急性呼吸衰竭 

分 类 号：R563.8[医药卫生—呼吸系统]