无创正压通气在不停跳冠状动脉搭桥术后低氧血症患者中的应用  

Efficacy evaluation of non-invasive positive pressure ventilation in the treatment of hypoxemia after off-pump coronary-artery bypass grafting

作　　者：熊厚仁 洪洁 叶文娟[1] 江秀明 陈红[1] XIONG Houren;HONG Jie;YE Wenjuan;JIANG Xiuming;CHEN Hong(Cardiovascular Surgery ICU,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230022)

机构地区：[1]安徽医科大学第一附属医院心脏大血管外科ICU

出　　处：《中西医结合护理（中英文）》2019年第7期20-22,共3页Journal of Clinical Nursing in Practice

摘　　要：目的观察不停跳冠状动脉搭桥术(OPCABG)术后并发低氧血症患者应用无创正压通气(NPPV)的临床效果。方法选取OPCABG术后低氧血症患者80例,随机分为对照组和观察组,各40例,对照组患者接受常规治疗,给予经鼻导管联合面罩高流量吸氧,观察组在常规治疗的基础上使用NPPV辅助通气。观察2组动脉血气分析结果,包括氧合指数(PaO 2/FiO 2)、动脉血二氧化碳分压(PaCO 2)、血液酸碱度(pH)、血乳酸(Lac),平均动脉压(MAP)、心率(HR)、呼吸(RR)及不良事件发生情况。结果治疗2 h后,观察组PaO 2/FiO 2水平明显高于对照组,而PaCO 2、Lac、MAP、HR及RR水平明显低于对照组,差异均有统计学意义(P<0.05)。观察组平均ICU监护时间明显短于对照组,差异有统计学意义(P<0.05)。观察组治疗后急性呼吸衰竭、肺不张及再次气管插管发生率明显低于对照组,差异有统计学意义(P<0.05)。结论NPPV辅助通气可明显改善OPCABG术后低氧血症患者的症状,降低不良事件发生率和再插管率。Objective To evaluate the non-invasive positive pressure ventilation(NPPV)in the treatment of hypoxemia after off-pump coronary-artery bypass grafting(OPCABG).Methods Totally 80 cases patients with hypoxemia after OPCABG were randomly divided into observation group and control group,with 40 cases in each group.The control group received routine treatment and nasal combined with face mask high-flow oxygen inhalation.The observation group received NPPV treatment in addition to routine treatment.The Oxygen index(PaO 2/FiO 2),partial pressure of carbon dioxide(PaCO 2),blood pH,blood lactic acid(Lac),mean arterial pressure(MAP),heart rate(HR),respiration rate(RR)and incidence of adverse events were observed and compared between two groups.Results After 2 hours of treatment,the PaO 2/FiO 2 in the observation group was higher than that in the control group,the levels of PaCO 2,Lac,MAP,HR,RR in the observation group were lower than those in the control group(P<0.05).The ICU monitoring time in the observation group was shorter than that in the control group(P<0.05).The incidence of acute respiratory failure,atelectasis and re-intubation were lower in the observation group than those in the control group(P<0.05).Conclusion The NPPV therapy is effective to relieve hypoxemia after OPCABG and reduce the risk of adverse events and re-intubation.

关 键 词：无创正压通气 不停跳冠状动脉搭桥术 低氧血症 冠状动脉粥样硬化性心脏病 

分 类 号：R473.5[医药卫生—护理学]