无创机械通气治疗呼吸衰竭的临床研究(1)
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[摘要] 目的：探讨无创机械通气治疗呼吸衰竭的临床疗效，评价无创机械通气在治疗呼吸衰竭中的作用。方法：2009年1月~2010年12月我科收治的87例呼吸衰竭患者在常规治疗的基础上均采用BiPAP呼吸机进行无创机械通气治疗，观察患者的血气变化、临床转归、心率变化、血压变化及不良反应情况。结果：经无创机械通气治疗后，患者的pH值明显升高(7.15 vs 7.37，t=11.98，P=0)，血二氧化碳分压(PaCO2)明显降低[95.26 mm Hg(1 mm Hg=0.133 kPa) vs 73.29 mm Hg，t=12.08，P=0]，血氧分压(PaO2)明显升高(41.77 mm Hg vs 62.85 mm Hg，t=13.15，P=0)，心率(HR)明显降低(105.37次/min vs 82.53次/min，t=14.63，P=0)。治疗前后患者的收缩压(SBP)及舒张压(DBP)差异无统计学意义(P>0.05)。2例患者改为有创通气，占2.30%，1例死亡，占1.15%，其余均治疗好转；6例出现胃肠胀气，占6.90%，8例患者出现口鼻咽干燥症状，占9.20%，4例患者发生鼻面部皮肤压伤，占4.60%，10例患者表现出紧张、恐惧等情绪波动，占11.49%。结论：无创机械通气治疗各种原因引起的呼吸衰竭安全有效。
[关键词] 无创机械通气；呼吸衰竭；治疗
[中图分类号] R563.8 [文献标识码] A [文章编号] 1673-7210(2011)11(a)-036-02
Clinical research of noninvasive positive pressure ventilation in the treatment of respiratory failure
LIU Yiqun
Department of Respiratory Medicine, the Lianyuan City People's Hospital , Hu′nan Province, Loudi 417100, China
[Abstract] Objective: To study the clinical efficacy of noninvasive mechanical ventilation in the treatment of respiratory failure and evaluate the role of noninvasive mechanical ventilation in the treatment of respiratory failure. Methods: From January 2009 to December 2010, based on the routine treatment, 87 patients with respiratury failure receiving BiPAP respirator noninvasive mechanical ventilation were retrospectively analyzed, including the changes in pH, PaCO2, PaO2, HR, clinical outcomes and adverse reaction. Results: After the treatment of noninvasive mechanical ventilation, the pH value significantly improved (7.15 vs 7.37, t=11.98, P=0), PaCO2 significantly decreased [95.26 mm Hg(1 mm Hg=0.133 kPa) vs 73.29 mm Hg, t=12.08, P=0], PaO2 significantly increased (41.77 mm Hg vs 62.85 mm Hg, t=13.15, P=0), HR significantly improved (105.37 times/min vs 82.53 times/min, t=14.63, P=0). 2 patients were changed for invasive ventilation (2.30%), 1 patients died (1.15%), the others were improved. 6 patients occurred flatulence(6.90%), 8 patients occurred dry of mouth, nose and pharynx (9.20%), 4 patients occurred bruised skin of nose and face (4 ......
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