| 林泽辉 杜永明 陈国宁 李泉 郑智超.无创正压通气序贯治疗急性左心衰合并呼吸衰竭患者的时机选择[J].,2016,16(25):4919-4921 |
| 无创正压通气序贯治疗急性左心衰合并呼吸衰竭患者的时机选择 |
| Opportunity of Noninvasive Positive Pressure Ventilation SequentialTreatment for Patients with Acute Left Heart Failure Combined withRespiratory Failure |
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| DOI： |
| 中文关键词: 急性左心衰 呼吸衰竭 无创正压通气 有创通气治疗 |
| 英文关键词: Acute left heart failure Respiratory failure Noninvasive positive pressure ventilation Invasive ventilation |
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| 中文摘要: |
| 目的：探讨无创正压通气序贯治疗急性左心衰合并呼吸衰竭患者的时机选择。方法：选择2013 年6 月-2015 年8 月我院收
治的120例先行气管插管有创通气治疗的急性左心衰合并呼吸衰竭患者作为研究对象，病情得到控制后，按照拔管时间的长短
分为A、B、C 3组，各40 例，其中A 组在进行自主呼吸30 min 后拔管，B 组在进行自主呼吸2 h后拔管，C组在进行自主呼吸24 h
后拔管，拔管后全部患者均进行无创正压通气序贯治疗，比较3 组患者治疗后血气分析结果、呼吸机相关肺炎发生率及脱机成功
率。结果：①3 组患者无创正压通气治疗后的呼吸频率、心率、氧合指数、氧分压、二氧化碳分压及ph 值均无明显差异（t1=1.402，
t2=1.338，t1=0.738，t2=1.201，t1=0.969，t1=0.857，均P＞0.05）；② A 组患者的脱机成功率为7.50%，显著低于B 组的77.50%与C 组的
82.50%，差异具有统计学意义（P＜0.05）；A 组患者的再插管率为92.50%，显著高于B 组的22.50%与C 组的17.50%，比较差异具
有统计学意义（P＜0.05）；A 组患者的呼吸机相关肺炎发生率为45.00%，显著高于B 组的12.50%与C 组的10.00%，比较差异具
有统计学意义（P＜0.05）。结论：急性左心衰合并呼吸衰竭患者在自主呼吸超过2 h后拔管，进行无创正压通气序贯治疗，可明显
提高脱机成功率，降低再插管率和呼吸机相关肺炎发生率，值得临床推广。 |
| 英文摘要: |
| Objective:To explore the opportunity of noninvasive positive pressure ventilation sequential treatment for patients
with acute left heart failure combined with respiratory failure.Methods:Selected 120 cases of patients with acute left heart failure complicated
with respiratory failure in our hospital from June 2013 to August 2015 as the objects,after the illness were controled, all patients
were divided into three groups of A, B,C groups and with 40 patients in each group according to the time of pulled out the pipe, the pipe
ofA group was pulled out 30 min after spontaneous breathing, B group was after 2 h, while C group was after 24 h, and all patients were
treated with noninvasive positive pressure ventilation sequential, the blood gas analysis, the occurrence of ventilator associated pneumonia
and the success rate of off-line in the 3 groups were compared.Results:①Respiratory rate, heart rate, oxygen index, oxygen pressure,
oxygen partial pressure, carbon dioxide pressure and pH value in the 3 groups of patients were not significantly different (t1=1.402, t2=1.
338, t3=0.738, t4=1.201, t5=0.969, t6=0.857 P>0.0); ②Offline success rate of the A group was 7.50%, which was significantly lower than
77.50%of the B group and 82.50%of the C group, the differences were statistically significant (P< 0.05). The reintubation rate of the A
group was 92.50%, which was significantly higher than 22.50%of the B group and 17.50% of the C group, the differences were statistically
significant(P<0.05). The ventilator associated pneumonia incidence of the A group was 45.00%, which was significantly higher than
12.50%of the B group and 10.00%of the C group, the differences were statistically significant(P<0.05).Conclusion:Using non-invasive
positive pressure ventilation sequential treatment for patients with acute left heart failure combined with respiratory failure after extubation
of more than 2 h is able to significantly improve the success rate of weaning, reduce the reintubation rate,and the incidence of ventilator
associated pneumonia, which is worthy of clinical promotion. |
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