有创与无创序贯性机械通气治疗急性有机磷农药中毒中间综合征的研究  

Sequential invasive and non-invasive mechanical ventilation in intermediate syndrome due to acute organophosphate poisoning

作　　者：窦敬权[1] 王立毅[1] 彭晓东[1] 潘超雄[1] 孙杰[1] 吴金波[1] 

机构地区：[1]广东医学院附属医院急救中心,广东湛江524001

出　　处：《广东医学院学报》2003年第3期221-222,225,共3页Journal of Guangdong Medical College

摘　　要：目的 :评价机械通气早期拔管改换无创机械通气治疗急性有机磷农药中毒 (AOPP)中间综合征 (IMS)的治疗效果。方法 :选择接受气管插管和机械通气的AOPPIMS 10例 ,以同步间歇强制通气 +压力支持通气 (SIMV +PSV )方式行机械通气 ,待IMS控制时 ,改用经鼻面罩压力支持通气 +呼吸未正压 (PSV +PEEP)方式 (序贯治疗组 ) ;另对病情具有可比性的 10例患者按常规行有创继续机械通气治疗 (对照组 )。结果 :序贯治疗组的有创机械通气时间、总机械通气时间和住ICU时间均较对照组明显缩短 [( 8.0± 4.3 )vs( 2 2 .3± 1.5 )d ;( 12 .6± 6.1)vs( 2 2 .1± 1.5 )d ;( 14± 8)vs( 2 7± 13 )d ;P <0 .0 5 ] ;序贯治疗组中发生呼吸机相关性肺炎的例数较对照组显著减少 ( 1vs 7,P <0 .0 5 )。结论 :对AOPPIMS机械通气病例 ,以中间综合征控制窗为时机早期拔管 。Objective:To evaluate the therapeutic efficacy of early extubation and subsequent non invasive mechanical ventilation(MV) in intermediate syndrome(IMS) due to acute organophosphate poisoning(AOPP).Methods:Twenty patients with IMS were randomly allocated to 2 groups:treatment group accepted invasive MV and subsequent non invasive MV,whereas control group were treated with continuous invasive MV.Results:Compared with control group,the duration of invasive MV,total duration of ventilatory assistance,hospitalized time in ICU and incidence of ventilator associated pneumonia were significantly decreased in treatment graup( P< 0.05).Conclusion:Early extubation followed by non invasive MV could be an effective method in the treatment of IMS caused by AOPP. [

关 键 词：序贯性机械通气 治疗 急性有机磷农药中毒 中间综合征 

分 类 号：R595.4[医药卫生—内科学]