无创机械通气在重症肺炎合并急性呼吸衰竭中疗效分析.docVIP

无创机械通气在重症肺炎合并急性呼吸衰竭中疗效分析 　　【摘要】目的研究无创机械通气(NPPV)治疗重症肺炎合并急性呼吸衰竭(SP-ARF)的临床疗效。方法60例重症肺炎合并急性呼吸衰竭患者在征得患者家属同意的前提下随机分为两组, 所有患者均在常规治疗的前提下, 观察组应用NPPV治疗, 对照组给予鼻导管吸氧, 观察对比两组患者治疗前后血气分析和临床症状、体征等指标。结果两组患者治疗前血气分析指标pH、PaO2、PaCO2指标差异均无统计学意义(P0.05)；经过治疗之后, 两组患者上述指标均显著下降, 差异均有统计学意义(P0.05)。结论NPPV在临床应用效果满意, 临床效果优于单纯应用鼻导管吸氧的方式, 在有条件的医院应推广应用, 但在应用过程中, 在发现无创正压通气控制病情困难时, 应尽早行有创正压机械通气(IPPV)治疗。 　　【关键词】重症肺炎；呼吸衰竭；无创机械通气； 疗效分析 　　 　　Analysis of curative effect of noninvasive mechanical ventilation in the treatment of severe pneumonia patients with acute respiratory failure CHEN Guang-yan. Shandong Academy of Medical Sciences/Jinan University/Shandong Academy of Medical Sciences Institute of Medicine and Life Science, Jinan 250062, China 　　【Abstract】ObjectiveTo study the clinical effect of noninvasive mechanical ventilation(NPPV) in the treatment of severe pneumonia complicated with acute respiratory failure(SP-ARF). MethodsDivided 60 SP-ARF patients into observation group and control group under the consent of family, all patients received routine treatment. Observation group received NPPV, control group was treated with nasal catheter oxygen, blood gas analysis and clinical symptoms, signs and other indicators of two groups were observed before and after treatment. ResultsBlood gas indexes pH, PaO2, PaCO2 of two groups before treatment showed no significant difference(P0.05). ConclusionThe clinical application effect of noninvasive positive pressure ventilation(NPPV) is satisfactory, the clinical effect is better than simple application of nasal catheter oxygen manner, it should be popularized and applied in conditional hospital, but invasive positive pressure ventilation(IPPV) treatment should be applied when it is difficult control the disease with noninvasive positive pressure ventilation. 　　【Key words】Severe pneumonia; Respiratory failure; Noninvasive mechanical ventilation; Curative effect analysis急性呼吸衰竭(acute respiratory failure, ARF)是重症肺炎患者常见的临床表现, 本文称为重症肺炎合并急性呼吸衰竭(SP-ARF)［1］。有创机械通