无创正压通气与有创正压通气治疗急性呼吸衰竭的比较研究  

Comparison of healing effect of noninvasive positive pressure ventilation and invasive positive pressure ventilation in patients of acute respiratory failure

作　　者：李坚[1] 张德厚[1] 黄贤凤[1] 丁明[1] 束国荣[1] 孙丽萍[1] 

机构地区：[1]江苏大学附属医院呼吸科,江苏镇江212001

出　　处：《中国急救医学》2003年第8期528-530,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的　比较无创正压通气 (NPPV)和有创正压通气 (IPPV)救治急性呼吸衰竭 (ARF)的临床效果 ,评估NPPV在ARF治疗中的作用。方法　将各种原因所致ARF 5 2例患者随机分为NPPV组 (2 6例 )和IPPV组 (2 6例 ) ,在给予病因治疗同时分别实施NPPV和IPPV。观察分析两组患者在治疗过程中动脉血气变化、并发症的发生率及治疗结果。结果　NPPV组有 7例 (2 6 .9% )治疗失败转为气管插管IPPV ,其中 4例 (15 .4 % )死亡。IPPV组死亡 5例 (19.2 % ) ,两组死亡率无显著差异 (P >0 0 5 )。两组治疗有效患者在分别接受NPPV和IPPV治疗后 6h动脉血气有相似的显著改善。NPPV组患者机械通气时间和住院时间短于IPPV组 (P <0 .0 5 )。NPPV组的并发症发生率低于IPPV组 (P <0 .0 5 )。结论　在经过选择的ARF患者中 ,应用NPPV治疗的临床效果与IPPV相似。实施NPPV可缩短机械通气和住院时间 ,减少并发症。且因为无创伤性 ,NPPV可作为经过选择的ARF患者首选的通气支持治疗手段。Objective To compare the clinical efficacy of noninvasive positive pressure ventilation (NPPV) and invasive positive pressure ventilation (IPPV) in patients with acute respiratory failure (ARF), and evaluate the effect of NPPV on the treatment of ARF.Methods 52 patients with ARF caused by various disorders were divided randomly into NPPV group (26 cases) and IPPV group (26 cases). Patients in two groups were treated by NPPV through a face mask or IPPV with endotracheal intubation respectively when disorders causing ARF were managed by medical therapy. Arterial blood gases were analyzed, and the rate of complication and outcome were observed.Result In NPPV group, seven patients were transformed into IPPV for worsening condition and arterial blood gases. Mortality rate in NPPV group (15.4%) was similar to IPPV group (19.2%) (P>0.05). After 6 hours of ventilatory support therapy, artery blood gas of cured patients of two groups improved significantly and similarly. Duration of mechanical ventilation and hospital stay in patients receiving NPPV were significantly shorter than those in patients receiving IPPV (P<0.05). Rate of complication in NPPV group was markedly lower than that in IPPV group (P<0.05). Conclusion Clinical efficacy of NPPV were similar to IPPV in selected patients with ARF. Use of NPPV in patients with ARF might reduce duration of mechanical ventilation and hospital stay, and decrease rate of complication. NPPV might be the ventilatory support therapy of the first choice for the selected patients with ARF.

关 键 词：急性呼吸衰竭 无创正压通气 有创正压通气 

分 类 号：R563.8[医药卫生—呼吸系统]