无创机械通气治疗呼吸衰竭的临床研究.docx

无创机械通气治疗呼吸衰竭的临床研究[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（7.15vs7.37t=11.98P=0）血二氧化碳分压（PaCO2）明显降低[95.26mmHg（1mmHg=0.133kPa）vs73.29mmHgt=12.08P=0]血氧分压（PaO2）明显升高（41.77mmHgvs62.85mmHgt=13.15P=0）心率（HR）明显降低（105.37次/minvs82.53次/mint=14.63P=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）-036-02ClinicalresearchofnoninvasivepositivepressureventilationinthetreatmentofrespiratoryfailureLIUYiqunDepartmentofRespiratoryMedicinetheLianyuanCityPeople'sHospitalHu′nanProvinceLoudi417100China[Abstract]Objective:Tostudytheclinicalefficacyofnoninvasivemechanicalventilationinthetreatmentofrespiratoryfailureandevaluatetheroleofnoninvasivemechanicalventilationinthetreatmentofrespiratoryfailure.Methods:FromJanuary2009toDecember2010basedontheroutinetreatment87patientswithrespiraturyfailurereceivingBiPAPrespiratornoninvasivemechanicalventilationwereretrospectivelyanalyzedincludingthechangesinpHPaCO2PaO2HRclinicaloutcomesandadversereaction.Results:AfterthetreatmentofnoninvasivemechanicalventilationthepHvaluesignificantlyimproved(7.15vs7.37t=11.98P=0)PaCO2significantlydecreased[95.26mmHg(1mmHg=0.133kPa)vs73.29mmHgt=12.08P=0]PaO2significantlyincreased(41.77mmHgvs62.85mmHgt=13.15P=0)HRsignificantlyimproved(105.37times/minvs82.53times/mint=14.63P=0).2patientswerechangedforinvasiveventilation(2.30%)1patientsdied(1.15%)theotherswereimproved.6patientsoccurredflatulence(6.90%)8patientsoccurreddryofmouthnoseandpharynx(9.20%)4patients