无创正压通气治疗急性呼吸衰竭临床研究

摘要

Objective:To explore the clinical research on patients with acute respiratory failure treated by noninvasive positive pressure ventilation(NIPPV) and provide the clinical basis.Method:72 patients with acute respiratory failure were selected randomly from July 2012 to December 2013 in our hospital. According to the application of ventilation, they were divided into invasive mechanical ventilation group(the control group) and noninvasive positive pressure ventilation group (the observation group), which were 36 cases in each groups respectively. The main assessment indexes of two groups were PaO2, PaCO2 and SaO2 after 4 h and 24 h ventilation; mechanical ventilation, VAP occurrence rate.Result:In the observation group,4 h PaO2, PaCO2 ventilation and SaO2 were (82.77±1.68)mm Hg, (57.80±1.13)mm Hg,(77.19±5.46)%;24 h PaO2, ventilation PaCO2 and SaO2 were (92.48±1.41)mm Hg, (49.85±1.02)mm Hg,(93.83±6.07)%.In the control group,PaO2, PaCO2 4 h ventilation and SaO2 were (91.43±1.92)mm Hg,(52.37±0.81)mm Hg,(81.31±6.68)%,24 h PaO2,PaCO2 ventilation and SaO2 were (94.55±1.30)mm Hg,(50.34±0.89)mm Hg,(94.02±7.96)%,there was a statistically significant difference in ventilation 4 hours between the two groups(P<0.05), there was no significant differences in ventilation 24 hours.The incidence of VAP in the observation group was 8.33%, which was lower than 27.78% in the control group, the difference was statistically significant(P<0.05).Hospital stay in the observation group was (17.19±0.46)d, which was lower than (21.31±0.68)d in the control group, the difference was statistically significant(P<0.05).Conclusion:NIPPV could effectively improve the gas exchange of the patients with acute respiratory failure, without the need for tracheotomy, effectively avoid various complications occurred.%目的：探讨无创正压通气（NIPPV）治疗急性呼吸衰竭患者的临床效果，为临床治疗提供依据。方法：随机选择本院2012年7月-2013年12月急性呼吸衰竭患者72例，根据患者应用通气方式分为有创机械通气组（对照组）及无创正压通气组（观察组），两组各36例。评估两组通气4 h和24 h的动脉血氧分压（PaO2）、动脉二氧化碳分压（PaCO2）和动脉血氧饱和度（SaO2）；机械通气、呼吸机相关性肺炎（VAP）发生率等指标。结果：观察组通气4 h的PaO2、PaCO2和SaO2分别为（82.77±1.68）mm Hg、（57.80±1.13）%、（77.19±5.46）%，通气24 h分别为（92.48±1.41）mm Hg、（49.85±1.02）mm Hg、（93.83±6.07）%；对照组通气4 h的PaO2、PaCO2和SaO2分别为（91.43±1.92）mm Hg、（52.37±0.81）mm Hg、（81.31±6.68）%，通气24 h分别为（94.55±1.30）mm Hg、（50.34±0.89）mm Hg、（94.02±7.96）%，两组比较通气4 h差异有统计学意义（P<0.05），而通气24 h差异无统计学意义；观察组VAP发生率为8.33%，低于对照组的27.78%，差异有统计学意义（P<0.05）；观察组住院时间为（17.19±0.46）d，低于对照组的（21.31±0.68）d，差异有统计学意义（P<0.05）。结论：NIPPV能够有效改善急性呼吸衰竭患者的气体交换，可以有效减少多种并发症的发生。