神经外科危重患者80例的呼吸支持治疗 (pdf)

    [摘要] 目的 总结分析我院神经外科2000～2005年对脑外伤和脑出血伴急性呼吸窘迫综合征(ARDS)患者采用呼吸机支持治疗80例的临床应用经验。方法 回顾我院神经外科2000～2005年对脑外伤和脑出血伴ARDS患者采用双水平气道正压(BiPAP)通气模式进行呼吸机支持治疗及采用连续脉搏血氧饱和度(SpO2)监测和间断血气分析方法来指导呼吸机支持治疗的临床病例80例。结果 80例中有26例死亡，其余病例经呼吸机支持治疗1～7天后呼吸功能均得到恢复，病情稳定后转普通病房。结论 BiPAP通气模式更适用于神经外科危重患者伴ARDS需呼吸机支持治疗的患者。采用连续SpO2监测和间断血气分析方法指导呼吸机支持治疗是基层医院简便易行的监测手段。

    [关键词] 呼吸机；重症监护室；气管切开

    On respiration support treatment for 80 cases of severely Ⅲ patients of neurosurgery department

    YANG Guo-ping.Department of Neurosurgery,Wuhan First Hospital,Wuhan 430022,China

    [Abstract] Objective To sum up and analyze the clinic application experience in respiration support treatment of 80 cases of patients suffering from brain trauma and cerebral hemorrhage with acute respiratory distress syndrome (ARDS) gathered by the Department of Neurosurgery of our hospital during 2000 to 2005.Methods Review the adoption of bi-level positive airway pressure (BiPAP) mode supported by breathing machines and the adoption of continuous monitoring on pulse oxygen saturation (SpO2) as well as discontinuous blood gas analysis as guidance for treatment of clinic 80 cases suffering from brain trauma and cerebral hemorrhage with ARDS.Results Of the 80 cases,26 died,and the rest recovered in respiratory functions and moved to common wards with stable status after receiving 1～7 days of treatment supported by breathing machines.Conclusion The BiPAP mode is more applicable to seriously ill patients with ARDS who are in need of supported breathing machines in Neurosurgery Department.The methods of continuous SpO2 monitoring and discontinuous blood gas analysis for guiding the treatment supported by breathing machines are easy and convenient monitoring means to be adopted by base-level hospitals. ......