中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
2期
116-118
,共3页
郭青云%李文%徐浩明%王天昊%宋祖军%池春
郭青雲%李文%徐浩明%王天昊%宋祖軍%池春
곽청운%리문%서호명%왕천호%송조군%지춘
无创正压通气%急性肺水肿%血气分析
無創正壓通氣%急性肺水腫%血氣分析
무창정압통기%급성폐수종%혈기분석
Non-invasive positive pressure ventilation%Acute pulmonary edema%Blood gas analysis
目的 研究无创正压通气(BiPAP)对急性肺水肿患者心率(HR)、呼吸频率(RR)及动脉血气的影响.方法 将58例急性肺水肿患者随机分为两组,对照组(29例)给予吸氧、强心、利尿、扩血管等常规治疗,干预组(29例)在上述常规治疗的基础上,加用BiPAP治疗.4h后,比较两组患者的HR、RR、动脉血气变化,出院时统计患者住院时间及行有创通气的发生率.结果 干预组治疗前HR、RR、氧饱和度(SaO2)和氧分压(PaO2)分别为(124±12)次/min、(37±5)次/min、(81.4±5.4)％和(53.2±5.4)mmHg,治疗后上述4项指标均有明显改善,HR、RR、SaO2和PaO2分别为(83±6)次/min(t =5.372,P＜ 0.01)、(19±8)次/min(t=4.285,P＜0.01)、(94.1±4.2)％(t=2.731,P ＜0.05)和(89.1±8.5)mm Hg(t=5.763,P＜0.01).对照组治疗前HR、RR、SaO2和PaO2分别为(123±11)次/min、(36±7)次/min、(81.8±5.7)％和(53.5±4.6)mm Hg,治疗后上述4项指标亦有明显改善,HR、RR、SaO2和PaO2分别为(95±8)次/min(t=3.459,P＜0.01)、(24±6)次/min(t =3.127,P＜0.01)、(88.3±4.5)％(t=2.314,P＜0.05)和(72.8 ±9.5)mm Hg(t=3.756,P＜0.01).干预组治疗后HR、RR、SaO2及PaO2较对照组改善更明显(t值分别为2.311、2.115、2.176、2.982,P＜0.05或P＜0.01)；干预组住院时间(9±3)d明显短于对照组[(15±4)d,t=3.763,P＜0.01]；干预组有创通气的发生率(6.89％)亦低于对照组(17.24％),但差异尚无统计学意义(x2=1.642,P＞0.05).结论 BiPAP能有效改善急性肺水肿患者HR、RR及血气分析指标,缩短住院时间,降低有创通气的发生率,具有较好的临床应用价值.
目的 研究無創正壓通氣(BiPAP)對急性肺水腫患者心率(HR)、呼吸頻率(RR)及動脈血氣的影響.方法 將58例急性肺水腫患者隨機分為兩組,對照組(29例)給予吸氧、彊心、利尿、擴血管等常規治療,榦預組(29例)在上述常規治療的基礎上,加用BiPAP治療.4h後,比較兩組患者的HR、RR、動脈血氣變化,齣院時統計患者住院時間及行有創通氣的髮生率.結果 榦預組治療前HR、RR、氧飽和度(SaO2)和氧分壓(PaO2)分彆為(124±12)次/min、(37±5)次/min、(81.4±5.4)％和(53.2±5.4)mmHg,治療後上述4項指標均有明顯改善,HR、RR、SaO2和PaO2分彆為(83±6)次/min(t =5.372,P＜ 0.01)、(19±8)次/min(t=4.285,P＜0.01)、(94.1±4.2)％(t=2.731,P ＜0.05)和(89.1±8.5)mm Hg(t=5.763,P＜0.01).對照組治療前HR、RR、SaO2和PaO2分彆為(123±11)次/min、(36±7)次/min、(81.8±5.7)％和(53.5±4.6)mm Hg,治療後上述4項指標亦有明顯改善,HR、RR、SaO2和PaO2分彆為(95±8)次/min(t=3.459,P＜0.01)、(24±6)次/min(t =3.127,P＜0.01)、(88.3±4.5)％(t=2.314,P＜0.05)和(72.8 ±9.5)mm Hg(t=3.756,P＜0.01).榦預組治療後HR、RR、SaO2及PaO2較對照組改善更明顯(t值分彆為2.311、2.115、2.176、2.982,P＜0.05或P＜0.01)；榦預組住院時間(9±3)d明顯短于對照組[(15±4)d,t=3.763,P＜0.01]；榦預組有創通氣的髮生率(6.89％)亦低于對照組(17.24％),但差異尚無統計學意義(x2=1.642,P＞0.05).結論 BiPAP能有效改善急性肺水腫患者HR、RR及血氣分析指標,縮短住院時間,降低有創通氣的髮生率,具有較好的臨床應用價值.
목적 연구무창정압통기(BiPAP)대급성폐수종환자심솔(HR)、호흡빈솔(RR)급동맥혈기적영향.방법 장58례급성폐수종환자수궤분위량조,대조조(29례)급여흡양、강심、이뇨、확혈관등상규치료,간예조(29례)재상술상규치료적기출상,가용BiPAP치료.4h후,비교량조환자적HR、RR、동맥혈기변화,출원시통계환자주원시간급행유창통기적발생솔.결과 간예조치료전HR、RR、양포화도(SaO2)화양분압(PaO2)분별위(124±12)차/min、(37±5)차/min、(81.4±5.4)％화(53.2±5.4)mmHg,치료후상술4항지표균유명현개선,HR、RR、SaO2화PaO2분별위(83±6)차/min(t =5.372,P＜ 0.01)、(19±8)차/min(t=4.285,P＜0.01)、(94.1±4.2)％(t=2.731,P ＜0.05)화(89.1±8.5)mm Hg(t=5.763,P＜0.01).대조조치료전HR、RR、SaO2화PaO2분별위(123±11)차/min、(36±7)차/min、(81.8±5.7)％화(53.5±4.6)mm Hg,치료후상술4항지표역유명현개선,HR、RR、SaO2화PaO2분별위(95±8)차/min(t=3.459,P＜0.01)、(24±6)차/min(t =3.127,P＜0.01)、(88.3±4.5)％(t=2.314,P＜0.05)화(72.8 ±9.5)mm Hg(t=3.756,P＜0.01).간예조치료후HR、RR、SaO2급PaO2교대조조개선경명현(t치분별위2.311、2.115、2.176、2.982,P＜0.05혹P＜0.01)；간예조주원시간(9±3)d명현단우대조조[(15±4)d,t=3.763,P＜0.01]；간예조유창통기적발생솔(6.89％)역저우대조조(17.24％),단차이상무통계학의의(x2=1.642,P＞0.05).결론 BiPAP능유효개선급성폐수종환자HR、RR급혈기분석지표,축단주원시간,강저유창통기적발생솔,구유교호적림상응용개치.
Objective To investigate the change of HR,RR and arterial blood gas in the treatment of BiPAP ventilation in patients with acute pulmonary.Methods Fifty eight patients with acute pulmonary edema were randomized into two groups.The control group(n =29)were given conventional general treatment only,but treatment group(n =29)were given BiPAP ventilation besides conventional treatment.4 h later,heart rate (HR),respiratory rate(RR),SaO2,pH,PaO2 and PaCO2 were compared between the two groups.Hospitalization duration and incidence of invasive mechanical ventilation were recorded after discharge.Results Compared with pre-treatment,HR,RR,SaO2 and PaO2 in treatment group were improved significantly(HR 124 ± 12 beat/min vs 83 ±6 beat/min,t =5.372,P ＜0.01)(RR 37 ±5 beat/min vs 19 ± 8 beat/min,t =4.285,P ＜0.01)(SaO2 81.4％ ±5.4％ vs94.1％ ±4.2％,t=2.731,P＜0.05)(PaO2 53.2±5.4 mm Hg vs 89.1 ±8.5 mm Hg,t=5.763,P ＜0.O1).And these four indicators were also improved in control group after treatment,(HR 123 ± 10 beat/min vs 95 ± 8 beat/min,t =t =3.459,P ＜ 0.01)(RR 36 ± 7 beat/min vs 24 ± 6 beat/min,t =3.127,P ＜0.01)(SaO2 81.8％ ±5.7％ vs 88.3 ±4.5％％,t =2.314,P ＜0.05)(PaO2 53.5 ±4.6 mm Hg vs 72.8 ±9.5 mm Hg,t =3.756,P ＜0.01).HR,RR,SaO2 and PaO2 in treatment group were more significantly improved than that of control group(P ＜ 0.01 or P ＜ 0.05).Hospitalization duration in treatment group was significantly shorter than that of control group(9 d vs 15 d,t =3.763,P ＜ 0.01).The incidence of invasive ventilation were lower than that of control group too(but P ＞ 0.05.Conclusion These results suggested that BiPAP ventilation can regulate HR RR and blood gas value to accetable levels,shorten hoptipitalization duration and reduce the incidence of invasive ventilation.It is proved to be an effective therapeutic technique in the treatment of acute pulmonary edema patients.
