中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
20期
34-36
,共3页
重症肺炎%呼吸衰竭%无创机械通气%疗效分析
重癥肺炎%呼吸衰竭%無創機械通氣%療效分析
중증폐염%호흡쇠갈%무창궤계통기%료효분석
Severe pneumonia%Respiratory failure%Noninvasive mechanical ventilation%Curative effect analysis
目的：研究无创机械通气(NPPV)治疗重症肺炎合并急性呼吸衰竭(SP-ARF)的临床疗效。方法60例重症肺炎合并急性呼吸衰竭患者在征得患者家属同意的前提下随机分为两组,所有患者均在常规治疗的前提下,观察组应用NPPV治疗,对照组给予鼻导管吸氧,观察对比两组患者治疗前后血气分析和临床症状、体征等指标。结果两组患者治疗前血气分析指标pH、PaO2、PaCO2指标差异均无统计学意义(P>0.05)；经过治疗之后,两组患者上述指标均显著下降,差异均有统计学意义(P<0.05)；观察组治疗之后上述指标均显著低于对照组,差异有统计学意义(P<0.05)。观察组因病情恶化改有创机械通气3例(10.00%),对照组改有创机械通气14例(46.67%),两组差异有统计学意义(P<0.05)；观察组平均住院时间(12.57±5.30)d,显著少于对照组(21.48±6.30)d,差异有统计学意义(P<0.05)；因患者出现病情恶化改有创机械通气,观察组抢救无效死亡1例(3.33%),对照组3例(3.33%),两组差异无统计学意义(P>0.05)。结论 NPPV在临床应用效果满意,临床效果优于单纯应用鼻导管吸氧的方式,在有条件的医院应推广应用,但在应用过程中,在发现无创正压通气控制病情困难时,应尽早行有创正压机械通气(IPPV)治疗。
目的：研究無創機械通氣(NPPV)治療重癥肺炎閤併急性呼吸衰竭(SP-ARF)的臨床療效。方法60例重癥肺炎閤併急性呼吸衰竭患者在徵得患者傢屬同意的前提下隨機分為兩組,所有患者均在常規治療的前提下,觀察組應用NPPV治療,對照組給予鼻導管吸氧,觀察對比兩組患者治療前後血氣分析和臨床癥狀、體徵等指標。結果兩組患者治療前血氣分析指標pH、PaO2、PaCO2指標差異均無統計學意義(P>0.05)；經過治療之後,兩組患者上述指標均顯著下降,差異均有統計學意義(P<0.05)；觀察組治療之後上述指標均顯著低于對照組,差異有統計學意義(P<0.05)。觀察組因病情噁化改有創機械通氣3例(10.00%),對照組改有創機械通氣14例(46.67%),兩組差異有統計學意義(P<0.05)；觀察組平均住院時間(12.57±5.30)d,顯著少于對照組(21.48±6.30)d,差異有統計學意義(P<0.05)；因患者齣現病情噁化改有創機械通氣,觀察組搶救無效死亡1例(3.33%),對照組3例(3.33%),兩組差異無統計學意義(P>0.05)。結論 NPPV在臨床應用效果滿意,臨床效果優于單純應用鼻導管吸氧的方式,在有條件的醫院應推廣應用,但在應用過程中,在髮現無創正壓通氣控製病情睏難時,應儘早行有創正壓機械通氣(IPPV)治療。
목적：연구무창궤계통기(NPPV)치료중증폐염합병급성호흡쇠갈(SP-ARF)적림상료효。방법60례중증폐염합병급성호흡쇠갈환자재정득환자가속동의적전제하수궤분위량조,소유환자균재상규치료적전제하,관찰조응용NPPV치료,대조조급여비도관흡양,관찰대비량조환자치료전후혈기분석화림상증상、체정등지표。결과량조환자치료전혈기분석지표pH、PaO2、PaCO2지표차이균무통계학의의(P>0.05)；경과치료지후,량조환자상술지표균현저하강,차이균유통계학의의(P<0.05)；관찰조치료지후상술지표균현저저우대조조,차이유통계학의의(P<0.05)。관찰조인병정악화개유창궤계통기3례(10.00%),대조조개유창궤계통기14례(46.67%),량조차이유통계학의의(P<0.05)；관찰조평균주원시간(12.57±5.30)d,현저소우대조조(21.48±6.30)d,차이유통계학의의(P<0.05)；인환자출현병정악화개유창궤계통기,관찰조창구무효사망1례(3.33%),대조조3례(3.33%),량조차이무통계학의의(P>0.05)。결론 NPPV재림상응용효과만의,림상효과우우단순응용비도관흡양적방식,재유조건적의원응추엄응용,단재응용과정중,재발현무창정압통기공제병정곤난시,응진조행유창정압궤계통기(IPPV)치료。
Objective To study the clinical effect of noninvasive mechanical ventilation(NPPV) in the treatment of severe pneumonia complicated with acute respiratory failure(SP-ARF).Methods Divided 60 SP-ARF patients into observation group and control group under the consent of family, all patients received routine treatment. Observation group received NPPV, control group was treated with nasal catheter oxygen, blood gas analysis and clinical symptoms, signs and other indicators of two groups were observed before and after treatment.Results Blood gas indexes pH, PaO2, PaCO2 of two groups before treatment showed no significant difference(P<0.05); after treatment, above indexes of two groups were significantly decreased, there was significant difference(P<0.05); after treatment, the above indexes of observation group were significantly lower than those of control group, there was statistically significant difference(P<0.05), 3 cases(10%) in observation group modified with invasive mechanical ventilation because of exacerbation, 14 cases(46.67%) in control group modified with invasive mechanical ventilation, differences had no statistical significance between two groups(P<0.05); the average hospitalization time in observation group was (12.57±5.30)d, (21.48±6.30)d was significantly less than that in control group, there was statistical difference(P<0.05) for patients with worsening of the disease; when modified with invasive mechanical ventilation, 1 case(3.33%) died due to the rescue in observation group, 3 cases(3.33%) in control group, difference had no statistical significance between two groups(P>0.05).Conclusion The clinical application effect of noninvasive positive pressure ventilation(NPPV) is satisfactory, the clinical effect is better than simple application of nasal catheter oxygen manner, it should be popularized and applied in conditional hospital, but invasive positive pressure ventilation(IPPV) treatment should be applied when it is difficult control the disease with noninvasive positive pressure ventilation.
