摘要
目的:比较无创正压通气(Noninvasive positive pressure ventilation,NPPV)和有创正压通气I(nvasive positive pressureventilationI,PPV)在胸心外科救治急性呼吸衰竭(Acute respiratory failure,ARF)的临床效果,评估NPPV在ARF治疗中的作用。方法:随机选取胸心外科术后各种原因所致轻、中型ARF患者32例,随机分为NPPV组(16例)和IPPV组(16例),在给予病因治疗同时分别实施NPPV和IPPV。观察分析2组患者在治疗过程中动脉血气变化、并发症的发生率及治疗结果。结果:NPPV组有5例(31.25%)治疗失败转为气管插管IPPV,其中3例(18.75%)死亡I。PPV组死亡4例(25%)。2组治疗有效患者在分别接受NPPV和IPPV治疗后6 h动脉血气有相似的改善。NPPV组患者机械通气时间和住院时间短于IPPV组(P<0.05)。NPPV组的并发症发生率低于IPPV组(P<0.05)。结论:在胸心外科术后ARF患者中,应用NPPV治疗的临床效果与IPPV相似。实施NPPV可缩短机械通气和住院时间,减少并发症。且因为无创性,NPPV可作为病情严重程度在一定范围内的ARF患者首选的通气支持治疗手段。
Objective：To compare the clinical effects of noninvasive positive pressure ventilation（NPPV） and invasive positive pressure ventilation（IPPV） in patients with acute respiratory failure（ARF）,and evaluate the effect of NPPV on the treatment of ARF.Methods：32 patients with Light,medium type ARF caused by various disorders were divided randomly into NPPV group（16 cases） and IPPV group（16 cases）.Patients in two groups were treated by NPPV through a face mask or IPPV with endotracheal intubation respectively while medical therapy.Arterial blood gases were analyzed,and the rate of complication and outcome were observed.Results：In NPPV group,5 patients were transformed into IPPV for worsening condition and arterial blood gases.mortality rate in NPPV group（18.75%）was lower compared to IPPV group（25%）（P〈0.05）.After 6 hours of ventilatory support therapy,artery blood gas of cured patients of two groups improved significantly and similarly.Duration of mechanical ventilation and hospital stay in patients receiving NPPV were significantly shorter than those in patients receiving IPPV（P〈0.05）.Rate of complication in NPPV group was lower than that in IPPV group（P〈0.05）.Conclusion：Clin ical efficacy of NPPV were similar to IPPV in selected patients with ARF.Use of NPPV in patients with ARF might reduce duration of mechanical ventilation and hospital stay,and decrease rate of complication.NPPV might be the first choice for ventilatory support in selected patients with ARF.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2011年第6期744-747,共4页
Journal of Chongqing Medical University
关键词
胸心外科
急性呼吸衰竭
无创正压通气
有创正压通气
cardiothoracic
acute respiratory failure
noninvasive positive pressure ventilation
invasive positive pressure ventilation
作者简介
黄春（1973-），男，主治医师，博士，研究方向：胸心外科学。
