国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2013年
4期
270-272
,共3页
杜友谊%吕祝庆%孙德彬%周家峰%孙蕾
杜友誼%呂祝慶%孫德彬%週傢峰%孫蕾
두우의%려축경%손덕빈%주가봉%손뢰
序贯通气%急性胰腺炎%急性呼吸窘迫综合征
序貫通氣%急性胰腺炎%急性呼吸窘迫綜閤徵
서관통기%급성이선염%급성호흡군박종합정
Sequential mechanical ventilation%Acute pancreatitis%Acute respiratory distress syndrome
目的 研究序贯通气对于急性胰腺炎所致急性呼吸窘迫综合征的临床效果.方法 将我院ICU于2009年5月至2011年5月期间收治的72例由于急性胰腺炎所致的急性呼吸窘迫综合征患者作为研究对象,将所有患者按照随机分组原则分为治疗组(序贯通气组)与对照组(机械通气组),各36例,其中治疗组采用序贯通气法治疗,对照组采用普通机械通气法治疗.对比两组患者于治疗前、治疗后16h及拔管时PaO2、PaCO2、pH值以及无创通气时间、机械通气时间、死亡率、治愈率及不良反应发生率.结果 ①序贯通气组有创通气时间为(2.34±1.24)d,少于机械通气组有创通气时间[(5.21±2.32)d,t=3.230,P＜0.05]；②序贯通气组总机械通气时间为(4.38±2.15)d,与机械通气组总机械通气时间[(4.25±2.35)d]比较差异无统计学意义(t=3.230,P＞0.05)；③序贯通气组于治疗后16hpH平均值恢复正常,PaO2高于机械通气组(t=3.440,P＜0.05),PaCO2亦高于机械通气组(t=5.125,P＜0.05)；④序贯通气组呼吸机相关性肺炎发生率为8.3％,低于机械通气组(16.7％,x2=15.644,P＜0.05)；⑤序贯通气组治愈率(86.1％)高于机械通气组(75.0％),且不良反应发生率、死亡率均低于机械通气组.结论 使用有创-无创序贯通气治疗急性胰腺炎所致急性呼吸窘迫综合征,具有缩短有创通气时间、动脉血气水平恢复快、不良反应少、治愈率高等优点,值得于临床广泛推广使用.
目的 研究序貫通氣對于急性胰腺炎所緻急性呼吸窘迫綜閤徵的臨床效果.方法 將我院ICU于2009年5月至2011年5月期間收治的72例由于急性胰腺炎所緻的急性呼吸窘迫綜閤徵患者作為研究對象,將所有患者按照隨機分組原則分為治療組(序貫通氣組)與對照組(機械通氣組),各36例,其中治療組採用序貫通氣法治療,對照組採用普通機械通氣法治療.對比兩組患者于治療前、治療後16h及拔管時PaO2、PaCO2、pH值以及無創通氣時間、機械通氣時間、死亡率、治愈率及不良反應髮生率.結果 ①序貫通氣組有創通氣時間為(2.34±1.24)d,少于機械通氣組有創通氣時間[(5.21±2.32)d,t=3.230,P＜0.05]；②序貫通氣組總機械通氣時間為(4.38±2.15)d,與機械通氣組總機械通氣時間[(4.25±2.35)d]比較差異無統計學意義(t=3.230,P＞0.05)；③序貫通氣組于治療後16hpH平均值恢複正常,PaO2高于機械通氣組(t=3.440,P＜0.05),PaCO2亦高于機械通氣組(t=5.125,P＜0.05)；④序貫通氣組呼吸機相關性肺炎髮生率為8.3％,低于機械通氣組(16.7％,x2=15.644,P＜0.05)；⑤序貫通氣組治愈率(86.1％)高于機械通氣組(75.0％),且不良反應髮生率、死亡率均低于機械通氣組.結論 使用有創-無創序貫通氣治療急性胰腺炎所緻急性呼吸窘迫綜閤徵,具有縮短有創通氣時間、動脈血氣水平恢複快、不良反應少、治愈率高等優點,值得于臨床廣汎推廣使用.
목적 연구서관통기대우급성이선염소치급성호흡군박종합정적림상효과.방법 장아원ICU우2009년5월지2011년5월기간수치적72례유우급성이선염소치적급성호흡군박종합정환자작위연구대상,장소유환자안조수궤분조원칙분위치료조(서관통기조)여대조조(궤계통기조),각36례,기중치료조채용서관통기법치료,대조조채용보통궤계통기법치료.대비량조환자우치료전、치료후16h급발관시PaO2、PaCO2、pH치이급무창통기시간、궤계통기시간、사망솔、치유솔급불량반응발생솔.결과 ①서관통기조유창통기시간위(2.34±1.24)d,소우궤계통기조유창통기시간[(5.21±2.32)d,t=3.230,P＜0.05]；②서관통기조총궤계통기시간위(4.38±2.15)d,여궤계통기조총궤계통기시간[(4.25±2.35)d]비교차이무통계학의의(t=3.230,P＞0.05)；③서관통기조우치료후16hpH평균치회복정상,PaO2고우궤계통기조(t=3.440,P＜0.05),PaCO2역고우궤계통기조(t=5.125,P＜0.05)；④서관통기조호흡궤상관성폐염발생솔위8.3％,저우궤계통기조(16.7％,x2=15.644,P＜0.05)；⑤서관통기조치유솔(86.1％)고우궤계통기조(75.0％),차불량반응발생솔、사망솔균저우궤계통기조.결론 사용유창-무창서관통기치료급성이선염소치급성호흡군박종합정,구유축단유창통기시간、동맥혈기수평회복쾌、불량반응소、치유솔고등우점,치득우림상엄범추엄사용.
Objective To investigate effect of invasive-noninvasive sequential mechanical ventilation on treating patients with acute respiratory distress syndrome caused by severe acute pancreatitis.Methods 72 cases of acute respiratory distress syndrome caused by severe acture pancreatitis in our hospital from May 2009 to May 2011 were randomly divided into two groups with 36 cases in each:treatment group (sequential mechanical ventilation group) and control group (invasive ventilation group).PaO2,PaCO2,and pH were measured before treatment and 16 hours after treatment in both groups.The mechanical ventilation duration,case fatality,curative ratio,side effect incidence were analyzed.Results The invasive ventilation duration in treatment group [(2.34 ± 1.24) days] was shorter than that in control group [(5.21-t-2.32) days,t =3.230,P ＜0.05].There was no statistical significance in total mechancial ventilation duriation between two groups [(4.38±2.15) days vs (4.25±2.35) days,t =3.230,P ＞0.05].The level of pH was improved at 16th hour in treatment group.The level of PaO2 in treatment group was superior to that in control group (t =3.440,P ＜0.05),and PaCO2 was superior too (t =5.125,P ＜0.05).The incidence of vetilation associated pneumonia in treatment group was lower than that in control group (8.3ooo vs 16.7％,x2 =15.644,P ＜ 0.05).Moreover,the curative ratio in treatment group (86.1％) was higher than that in conrol group (75.0％).Conclusions The invasive-noninvasive sequential mechanical ventilation is more effective in patients with acute respiratory distress syndrome caused by severe actue pancreatitis by shortening the time of invasive ventilation duration and decreasing the incidence and case fatality of ventilation associated pneumonia.
