BiPAP无创通气治疗II型呼吸衰竭并肺性脑病临床疗效探讨(1)
[摘要] 目的 觀察分析BiPAP无创通气治疗II型呼吸衰竭并肺性脑病临床效果。 方法 随机选取该院2014年1月—2018年6月收治的II型呼吸衰竭并肺性脑病患者60例作为研究对象，按照治疗方法分为两组，每组30例，分别采用给予持续低流量吸氧(A组)及呼吸兴奋剂治疗和BiPAP无创通气(B组)治疗，对比两组的效果。结果 B组的治疗总有效率为86.67%，明显高于A组的56.67%(χ2=10.601，P<0.05)。治疗后两组的心率分别为(110.23±1.81)次/min和(98.24±3.12)次/min(t=18.207，P<0.05);呼吸频率分别为(27.05±1.62)次/min和(21.21±1.23)次/min(t=15.726，P<0.05);舒张压分别为(77.15±13.32)mmHg和(61.12±11.32)mmHg(t=5.023，P<0.05);收缩压分别为(125.32±12.26)mmHg和(112.12±11.21)mmHg(t=4.352，P<0.05);两组患者治疗后的心率、呼吸和血压等相关指标均有明显改善，而B组的改善幅度明显大于A组(P<0.05)。治疗后两组的PaO2分别为(67.18±10.76)mmHg和(86.34±17.76)mmHg(t=5.054，P<0.05);PaCO2分别为(52.34±7.68)mmHg和(58.78±7.65)mmHg(t=2.910，P<0.05);SpO2分别为(86.76±7.65)%和(97.51±5.58)%(t=6.218，P<0.05)。治疗后两组患者的PaO2、PaCO2和SpO2等各项动脉血气指标均有明显改善，而B组的改善幅度明显大于A组(P<0.05)。两组的血压波动、心律失常、恶心呕吐、皮肤瘙痒等各种不良反应总发生率分别为6.67和8.89%，组间比较差异无统计学意义(χ2=0.155，P>0.05)。 结论 BiPAP无创通气治疗II型呼吸衰竭并肺性脑病，能够有效改善临床症状，促进气体交换和脑组织功能恢复，具有显著的临床应用效果。
[关键词] BiPAP无创通气;II型呼吸衰竭;肺性脑病
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2019)02(a)-0066-04
[Abstract] Objective To observe the clinical effect of BiPAP non-invasive ventilation in the treatment of type II respiratory failure with pulmonary encephalopathy. Methods A total of 60 patients with type II respiratory failure and pulmonary encephalopathy admitted to our hospital from January 2014 to June 2018 were enrolled. The patients were divided into two groups according to the treatment method. Each group had 30 cases， respectively. Flow oxygen inhalation (group A) and respiratory stimulant therapy and BiPAP noninvasive ventilation (group B) were compared， and the effects of the two groups were compared. Results The total effective rate of treatment in group B was 86.67%， which was significantly higher than that in group A 56.67% (x2=10.601， P<0.05). The heart rate of the two groups after treatment was (110.23±1.81) times/min and (98.24±3.12) times/min (t=18.207， P<0.05); the respiratory rate was (27.05±1.62) times/min and (21.21±1.23) times/min (t=15.726， P<0.05); diastolic blood pressure was (77.15±13.32) mmHg and (61.12±11.32) mmHg (t=5.023， P<0.05); systolic blood pressure was (125.32±12.26) mmHg and (112.12±11.21) mmHg (t=4.352， P<0.05); the heart rate， respiration and blood pressure of the two groups were significantly improved after treatment， while the improvement of group B was significantly greater than that of group A(P<0.05). The PaO2 of the two groups after treatment was (67.18±10.76) mmHg and (86.34±17.76) mmHg (t=5.054， P<0.05); PaCO2 was (52.34±7.68)mmHg and (58.78±7.65)mmHg (t= 2.910， P<0.05); SpO2 was (86.76±7.65)% and (97.51±5.58)%， respectively (t=6.218， P<0.05). After treatment， the arterial blood gas indexes of PaO2， PaCO2 and SpO2 were significantly improved in the two groups， and the improvement in group B was significantly greater than that in group A (P<0.05). The total incidence of adverse reactions such as blood pressure fluctuation， arrhythmia， nausea and vomiting， and skin itching were 6.67 and 8.89%， respectively. There was no statistically significant difference between the two groups (χ2=0.155， P>0.05). Conclusion BiPAP non-invasive ventilation for type II respiratory failure and pulmonary encephalopathy can effectively improve clinical symptoms， promote gas exchange and recovery of brain tissue function， and has significant clinical application effects., http://www.100md.com(蓝艳春)
[关键词] BiPAP无创通气;II型呼吸衰竭;肺性脑病
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2019)02(a)-0066-04
[Abstract] Objective To observe the clinical effect of BiPAP non-invasive ventilation in the treatment of type II respiratory failure with pulmonary encephalopathy. Methods A total of 60 patients with type II respiratory failure and pulmonary encephalopathy admitted to our hospital from January 2014 to June 2018 were enrolled. The patients were divided into two groups according to the treatment method. Each group had 30 cases， respectively. Flow oxygen inhalation (group A) and respiratory stimulant therapy and BiPAP noninvasive ventilation (group B) were compared， and the effects of the two groups were compared. Results The total effective rate of treatment in group B was 86.67%， which was significantly higher than that in group A 56.67% (x2=10.601， P<0.05). The heart rate of the two groups after treatment was (110.23±1.81) times/min and (98.24±3.12) times/min (t=18.207， P<0.05); the respiratory rate was (27.05±1.62) times/min and (21.21±1.23) times/min (t=15.726， P<0.05); diastolic blood pressure was (77.15±13.32) mmHg and (61.12±11.32) mmHg (t=5.023， P<0.05); systolic blood pressure was (125.32±12.26) mmHg and (112.12±11.21) mmHg (t=4.352， P<0.05); the heart rate， respiration and blood pressure of the two groups were significantly improved after treatment， while the improvement of group B was significantly greater than that of group A(P<0.05). The PaO2 of the two groups after treatment was (67.18±10.76) mmHg and (86.34±17.76) mmHg (t=5.054， P<0.05); PaCO2 was (52.34±7.68)mmHg and (58.78±7.65)mmHg (t= 2.910， P<0.05); SpO2 was (86.76±7.65)% and (97.51±5.58)%， respectively (t=6.218， P<0.05). After treatment， the arterial blood gas indexes of PaO2， PaCO2 and SpO2 were significantly improved in the two groups， and the improvement in group B was significantly greater than that in group A (P<0.05). The total incidence of adverse reactions such as blood pressure fluctuation， arrhythmia， nausea and vomiting， and skin itching were 6.67 and 8.89%， respectively. There was no statistically significant difference between the two groups (χ2=0.155， P>0.05). Conclusion BiPAP non-invasive ventilation for type II respiratory failure and pulmonary encephalopathy can effectively improve clinical symptoms， promote gas exchange and recovery of brain tissue function， and has significant clinical application effects., http://www.100md.com(蓝艳春)