Ⅰ型呼吸衰竭和Ⅱ型呼吸衰竭患者在丙泊酚浅镇静下应用无创呼吸机辅助通气疗效对比分析  

Comparative Analysis of the Effect of Non-invasive Ventilator Assisted Ventilation in Patients with Type Ⅰ Respiratory Failure and Type Ⅱ Respiratory Failure under Propofol Light Sedation

作　　者：周亚锋 李德平 陈文冲 罗建立 ZHOU Yafeng;LI Deping;CHEN Wenchong;LUO Jianli(Department of Critical Care Medicine,Fifth People's Hospital of Foshan City,Foshan,Guangdong Province,528211 China)

机构地区：[1]广东省佛山市第五人民医院重症医学科,广东佛山528211

出　　处：《中外医疗》2021年第14期20-22,共3页China & Foreign Medical Treatment

基　　金：佛山市卫生和健康局医学科研课题(20200254)。

摘　　要：目的观察探讨Ⅰ型呼吸衰竭和Ⅱ型呼吸衰竭使用无创呼吸机不耐受患者在丙泊酚镇静下的通气效果。方法方便选取2020年1-10月该院收住的符合条件要求的呼吸衰竭患者129例作为研究对象,将患者分为Ⅰ型呼吸衰竭患者组和Ⅱ型呼吸衰竭患者组,在丙泊酚镇静下使用呼吸机治疗3 h、24 h、48 h时,对比两组患者的心率(HR)、呼吸频率(RR)、pH、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))、治疗有效率、治疗失败率(需气管插管有创通气为失败)和呼吸机相关肺炎的发生情况。结果治疗后3 h和24 h,Ⅰ型呼吸衰竭患者组的PaO_(2)显著性高于Ⅱ型呼吸衰竭患者组,差异有统计学意义(P<0.05),PaCO_(2)显著性低于Ⅱ型呼吸衰竭患者组,差异有统计学意义(P<0.05);且Ⅰ型呼吸衰竭患者组的治疗失败率7.69%和呼吸机相关肺炎发生率1.54%均低于Ⅱ型呼吸衰竭患者组,有效率92.31%显著高于Ⅱ型呼吸衰竭患者组,差异有统计学意义(χ^(2)=5.165、4.401、5.165,P<0.05)。结论丙泊酚浅镇静下应用无创呼吸机辅助通气对于Ⅰ型呼吸衰竭患者疗效优于Ⅱ型呼吸衰竭患者,且Ⅰ型呼吸衰竭患者应用后不良反应发生情况更少,提高无创辅助通气在不同类型呼吸衰竭患者中应用的整体认识和水平。Objective To observe and investigate the ventilation effect of propofol sedation in patients with type Ⅰ respiratory failure and type Ⅱ respiratory failure who are intolerant of non-invasive ventilator use. Methods From January to October 2020, 129 eligible patients with respiratory failure admitted to the hospital were conveniently selected as the research objects. The patients were divided into type Ⅰ respiratory failure patient group and type Ⅱ respiratory failure patient group. Under propofol sedation, the heart rate(HR), respiratory rate(RR), pH, arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)), and blood oxygen saturation degree(SaO_(2)), effective rate of treatment,treatment failure rate(tracheal intubation required for invasive ventilation is failure), and the occurrence of ventilator-related pneumonia were compared between the two groups of patients when they were treated with a ventilator for 3 h, 24 h, and 48 h. Results 3 h and 24 h after treatment, the PaO_(2) of the type Ⅰ respiratory failure patient group was significantly higher than that of the type Ⅱ respiratory failure patient group,the difference was statistically significant(P<0.05), and the PaCO_(2) was significantly lower than that of the type Ⅱ respiratory failure patient group,the difference was statistically significant(P <0.05);and the treatment failure rate of 7.69% in the type Ⅰ respiratory failure patient group and 1.54% of the ventilatorassociated pneumonia rate were lower than those in the type Ⅱ respiratory failure patient group, and the effective rate was 92.31% significantly higher than the type Ⅱrespiratory failure patient group, the difference was statistically significant (χ^(2)=5.165, 4.401, 5.165,P<0.05). Conclusion The effect of non-invasive ventilator-assisted ventilation under shallow sedation with propofol is better than that of patients with type Ⅰ respiratory failure, and there are fewer adverse reactions in patients with type Ⅰ respiratory fail

关 键 词：呼吸衰竭 丙泊酚镇静 无创呼吸机辅助通气 

分 类 号：R562[医药卫生—呼吸系统]