胸外伤后急性肺损伤的无创机械通气治疗效果观察

摘要

目的 探讨应用多功能呼吸机无创通气治疗胸部外伤所致急性肺损伤ALI.方法 对我院45例胸部外伤导致ALI患者进行前瞻性对照研究.观察无创通气组动脉血氧分压、氧合指数、呼吸频率及辅助呼吸肌动用评分,并对两组病死率、呼吸机并发症发生率、机械通气治疗时间及住院时间进行统计学分析.结果 无创通气组动脉血氧分压、氧合指数较通气前均有明显改善(P<0.05),呼吸频率及辅助呼吸肌动用评分在通气后12 h及撤机后较通气前下降(P<0.05);无创通气组机械通气并发症发生率、机械通气治疗时间及住院时间优于有创通气组(P<0.05).结论 无创机械通气是治疗胸部外伤所致急性肺损伤特别是恶化至急性呼吸窘迫综合征的有效方法.%Objective To evaluate the effect oi non-invasive ventilatory support ( NIV ) in the treatment oi patients with arute lung injury ( ALI) caused by thoiarir trauma. Methods 45 ALI patients caused by thoracic trauma between were randomly divided into two groups. The observation group received NIV treatment and the control group received invasive mechanical ventilation ( IMV ) treatment. The level oi PaO2 , ratio oi PaO2/FiO2, respiratory rate ( RR ) and score oi the accessory respiratory muscle use after the treatment were compared and analyzed between the two groups. Results The improvement oi PaO2 , PaO2/FiO2 , RR and score oi the accessory respiratory muscle use increased more obviously in the observation group than in the control group alter the treatment ( P <0. 05 ). The incidence oi ventilation complications and the duration oi ventilation and hospital stay were lower in the observation group than in the control group ( P < 0. 05 ). Conclusion Non-invasive ventilatory support is a very effective method ior ALI patients caused by thoracic trauma, especially ior those with acute respiratory distress syndrome.