不同无创通气模式对急性呼吸窘迫综合征患者血气指标及预后影响  

Effect of different noninvasive ventilation modes on blood gas index and prognosis in patients with acute respiratory distress syndrome

作　　者：王常永[1] 冯丽芝[1] 商敏[2] 周青山[1] 陈国忠[2] WANG Chang-yong;FENG Li-zhi;SHANG Min;ZHOU Qing-shan;CHEN Guo-zhong(Department of Critical Care Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院重症医学科,湖北武汉430060 [2]武汉大学人民医院呼吸与危重症医学科,湖北武汉430060

出　　处：《创伤与急危重病医学》2019年第4期249-251,共3页Trauma and Critical Care Medicine

摘　　要：目的探讨不同无创通气模式对急性呼吸窘迫综合征(ARDS)患者血气指标及预后的影响。方法选取武汉大学人民医院自2016年9月至2018年9月收治的48例ARDS患者为研究对象。按照随机数字表法分为双水平气道正压通气(BiPAP)组与持续气道正压通气(CPAP)组,每组各24例。比较两组患者的血气指标、气管插管率、ICU住院时间、机械通气时间及ICU病死率。结果治疗后两组患者的动脉氧分压、血氧饱和度、氧合指数较治疗前均显著增加,差异有统计学意义(P<0.05)。治疗后两组间比较,差异无统计学意义(P>0.05)。BiPAP组的气管插管率为16.7%(4/24),显著低于CPAP组的29.1%(7/24),BiPAP组的ICU住院时间(14.4±10.0)d及机械通气时间(8.3±5.2)d显著低于CPAP组的ICU住院时间(19.3±8.2)d及机械通气时间(15.7±7.2)d,差异均有统计学意义(P<0.05)。两组患者的ICU病死率均为29.1%(7/24),差异无统计学意义(P>0.05)。结论ARDS患者使用BiPAP模式、CPAP模式无创通气均可有效改善氧合指数,但使用BiPAP模式患者气管插管的发生率更低,ICU住院时间、机械通气时间更短。Objective To investigate the effect of different non-invasive ventilation modes on indexes of arterial blood gases(ABG)and prognosis in patients with acute respiratory distress syndrome(ARDS). Methods A prospective study was performed on 48 cases of patients with ARDS who were admitted from September 2016 to September 2018.Patients were randomly divided into bi-level positive airway pressure(BiPAP)group and continuous positive airway pressure(CPAP)group with 24 cases in each group.Blood gas index,endotracheal intubation rate,ICU hospitalization time,mechanical ventilation time and ICU fatality rate were compared between the two groups. Results PaO 2,SaO 2 and PaO 2/FiO 2 in both groups was significantly higher than those before after treatment( P <0.05).There was no statitically significant difference between the two groups( P >0.05).The endotracheal intubation rates in BiPAP and CPAP group were 16.7%(4/24)and 29.1%(7/24),respectively.The ICU hospitalization time(14.4±10.0)days and mechanical ventilation time(8.3±5.2)days in BiPAP group were significantly lower than the ICU hospitalization time(19.3±8.2)days and mechanical ventilation time(15.7±7.2)days in CPAP group( P <0.05).The ICU fatality rates of both groups were 29.1%(7/24),with no statistically significant difference( P >0.05). Conclusion BiPAP and CPAP mode can effectively improve oxygenation index in patients with ARDS,the endotracheal intubation rates in patients with BiPAP mode is lower,meanwhile the ICU hospitalization time and the time of mechanical ventilation are shorter.

关 键 词：无创通气 急性呼吸窘迫综合征 双水平气道正压通气模式 持续气道正压通气模式 

分 类 号：R563[医药卫生—呼吸系统]