BiPAP无创通气对拔管后急性低氧性呼吸衰竭的影响

摘要

Objective:To explore the effect of noninasie entilation on acute respiratory failure of patients with extubation. Methods:31 patients with blood oxygen shortage after endotracheal intubation or tracheotomy decannulation were randomly divide into two groups,conventional treatment group and noninvasive ventilation group,compare the blood gas analysis results and breathing rates at 1,6,12,24 h.Results:Compared with conventional treatment group,PaO2/FiO2 of patients in noninvasive ventilation group was increased significantly at 1,6,12 h,but no obvious difference in 24 h. Compared with conventional treatment group,PaCO2 of patients in noninvasive ventilation group was reduced significantly in 1,6,12 h (P<0.05),but no obvious difference in 24 h.Compared with conventional treatment group,respiratory frequency of patients in noninvasive ventilation group speed up significantly (P<0.05) in 1 h,but no obvious difference in 6,12,24 h. After treatment,rate of arrhythmia,rate of dyspnea,rate of cyanosis,rate of restlessness of noninvasive ventilation group in 1,6,12 h were lower than that of conventional treatment group,but no obvious difference in 24 h .Conclusion:Noninvasive ventilation has effect on acute respiratory failure of patients with extubation,and it has certain feasibility and validity,and the clinical treatment may be the new strategy.%　　目的：探讨BiPAP无创通气对患者早期拔管后急性呼吸衰竭的影响.方法：将31例气管插管或气管切开拔管后出现急性低氧性呼吸衰竭的患者随机分配到常规处理组和无创通气组，在1、6、12、24 h时比较两组患者的血气分析结果和呼吸频率、心率失常、发绀及躁动.结果：与常规处理组相比，无创通气组在1、6、12 h时患者的PaO2/FiO2明显高，但两组在24 h时无明显差异；与常规处理组相比，无创通气组在1、6、12 h时患者的PaCO2明显低(P<0.05)，但两组在24 h时无明显差异；与常规处理组相比，无创通气组在1 h时患者的呼吸频率明显加快(P<0.05)，但两组在6、12、24 h时无明显差异.无创通气组在治疗后1、6、12 h患者的心率失常发生率、呼吸困难比率、发绀率及躁动率均较常规处理组降低更为明显，两组24 h时无明显差异.结论：应用BiPAP无创通气治疗早期拔管后的急性低氧性呼吸衰竭具有一定的可行性和有效性，可能是临床治疗的新策略.