不同压力支持水平无创正压通气对急性呼吸衰竭患者的疗效  

Efficacy of Non-invasive Positive Pressure Ventilation with Different Stress Support Levels in Patients with Acute Respiratory Failure

作　　者：赵华嗣[1] 谷玉雷[2] 赵华延 王华启[1] 张国俊[1] ZHAO Hua-si;GU Yu-lei;ZHAO Hua-yan;WANG Hua-qi;ZHANG Guo-jun(Department of respiratory medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Emergency ICU,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Surgical ICU,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院呼吸内一科,河南郑州450052 [2]郑州大学第一附属医院急诊重症监护室,河南郑州450052 [3]郑州大学第一附属医院外科重症监护室,河南郑州450052

出　　处：《河南医学研究》2020年第21期3860-3863,共4页Henan Medical Research

摘　　要：目的探讨应用不同压力支持水平无创正压通气(NIPPV)对急性呼吸衰竭(ARF)患者的疗效。方法纳入郑州大学第一附属医院呼吸科及急诊科2017年11月至2019年2月收治的71例ARF患者,按照纳入标准随机分为对照组(21例)、低压力支持组(27例)及高压力支持组(23例)。对照组接受常规治疗;高压力支持组接受高压力支持水平NIPPV,低压力支持组接受低压力支持水平NIPPV。比较3组患者治疗前后心率(HR)、呼吸频率(RR)、动脉二氧化碳分压(PaCO2)、动脉氧分压(PaO2)和pH值差异;比较3组患者的致死率、气管插管率与住院时间以及临床疗效。结果治疗后高压力支持组HR、RR和PaCO2均低于对照组及低压力支持组,PaO2和pH值均高于其他两组,差异有统计学意义(P<0.05)。高压力支持组气管插管率、死亡率均低于其他两组,住院时间短于其他两组,差异有统计学意义(P<0.05)。高压力支持组治疗有效率(91.3%)高于对照组(66.7%)和低压力支持组(77.8%),差异有统计学意义(P<0.05)。结论高压力支持水平NIPPV在ARF急诊治疗中能改善临床症状,提高治疗有效率,具有较高的临床价值。Objective To explore the effects of non-invasive positive pressure ventilation(NIPVV)with different pressures in acute respiratory failure(ARF)patients.Methods A total of 71 patients with acute respiratory failure admitted to the respiratory and emergency department of the first affiliated hospital of Zhengzhou university from November 2017 to February 2019 were randomly divided into control group(21 cases),low-stress support group(27 cases)and high-stress support group(23 cases)according to the inclusion criteria.High-pressure support group received high-pressure support level non-invasive positive pressure ventilation,and low-pressure support group received low-pressure support level non-invasive positive pressure ventilation.The differences of heart rate(HR),respiratory rate(RR),arterial partial carbon dioxide pressure(PaCO2),arterial partial oxygen pressure(PaO2)and pH value were compared before and after treatment among the three groups.The mortality,endotracheal intubation rate and length of stay and the clinical efficacy were compared in the three groups.Results After treatment,HR,RR and PaCO2 in the high-stress support group were lower than those in the control group and those in the low-pressure support group,and the PaO2 and pH values were higher than those in the other two groups,and the differences were statistically significant(P<0.05).Compared with the other two groups,the rate of endotracheal intubation,mortality were all lower and length of stay was shorter in the high-stress group,and the differences were statistically significant(P<0.05).The effective rate of treatment in the high-stress group(91.3%)was significantly higher than that in the control group(66.7%)and the low-pressure support group(77.8%),and the differences were statistically significant(P<0.05).Conclusion Non-invasive positive pressure ventilation with high pressure support level can improve the clinical symptoms and the effective rate of treatment,which has high clinical value in the emergency treatment of acute respiratory failu

关 键 词：无创正压通气 急性呼吸衰竭 高压力支持 

分 类 号：R563.8[医药卫生—呼吸系统]