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重庆医科大学附属第一医院中心ICU
纸质出版日期:2010,
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[1]古满平,丁福,范晶.无创正压通气在多发伤并发ALI/ARDS中的临床应用[J].重庆医科大学学报,2010,35(12):1884-1887.
Gu Man-ping, et al. Clinical evaluation of noninvasive positive pressure ventilation in multiple injury patients with acute lung injury and acute respiratory distress syndrome[J]. Journal of Chongqing Medical University, 2010,35(12):1884-1887.
[1]古满平,丁福,范晶.无创正压通气在多发伤并发ALI/ARDS中的临床应用[J].重庆医科大学学报,2010,35(12):1884-1887. DOI: 10.13406/j.cnki.cyxb.2010.12.039.
Gu Man-ping, et al. Clinical evaluation of noninvasive positive pressure ventilation in multiple injury patients with acute lung injury and acute respiratory distress syndrome[J]. Journal of Chongqing Medical University, 2010,35(12):1884-1887. DOI: 10.13406/j.cnki.cyxb.2010.12.039.
目的:探讨使用无创正压通气(Noninvasive positive pressure ventilation
NIPPV)治疗多发伤并发急性肺损伤/急性呼吸窘迫综合征(Acute lung injury/acute respiratory distress syndrome
ALI/ARDS)
总结双水平气道正压通气呼吸模式的临床应用。方法:回顾性分析75例多发伤并发ALI/ARDS患者使用NIPPV或有创机械通气(Invasive mechanical ventilationI
MV)的情况
比较两种通气方式治疗前及治疗后2 h动脉血气分析变化及机械通气时间。结果:NIPPV40例
有创通气35例。无创通气组及有创通气组通气2 h后病人动脉血氧分压(Arterial partial pressure of oxygen
PaO2)及血氧饱和度(Oxygen saturation
SaO2)较通气前明显提高(P<0.000 1)。无创通气组中5例无创通气3~5 d(平均4.2 d)后改IMV
4例因手术需全麻
先予以IMV 20~36 h后改为无创机械通气。35例无创通气3~18 d[平均(8±5.5)d]成功脱机
无1例死亡。IMV组通气5~20 d脱机[平均(9±5.5)d]
无1例死亡。两组机械通气时间比较无统计学意义(P>0.05)。两组间动脉血气分析治疗前、治疗后变化比较无统计学意义(P>0.05)。结论:多发伤后合并ALI/ARDS早期应用NIPPV治疗
采用双水平气道正压通气的呼吸模式
不仅可取得与IMV治疗相同的效果
而且能减少并发症
提高病人的舒适性。
Objective:To explore the importance of noninvasive positive pressure ventilation(NIPPV) in treating patients suffered from multiple injury accompanied with acute lung injury(ALI)/acute respiratory distress syndrome(ARDS)
and summarize the clinical usage of bi-level airway pressure ventilation mode in the treatment.Methods:The 75 cases with multiple injury complicated with ALI/ARDS were analyzed retrospectively and the following two groups were obtained:the positive pressure ventilation group
in abbreviation NIPPV
and the invasive mechanical ventilation group
in abbreviation IMV.The changes of arterial blood gas individually before and after 2 h treatment and the duration of using ventilation were compared between the two groups.Results:40 cases were enrolled into NIPPV group
and 35 cases belong to IMV group.The arterial partial pressure of oxygen(PaO2) and arterial oxygen saturation(SaO2) had significantly improved after 2 h NIPPV or IMV treatment(both P <0.000 1).5 patients changed to IMV after 3~5 days NIPPV(average=4.2 d)according to their conditions.4 patients who needed general anesthesia operations were given IMV for 20~36 h
then were changed to NIPPV.Duration of using NIPPV were 3~18 d(average=(8±5.5) d)
and duration of using IMV were 5~20 d(average=(9±5.5) d).The changes of arterial blood gas showed no significant difference between NIPPV and IMV at the statistic level of P>0.05.No patient died in two groups.Conclusion:The use of bi-level airway pressure ventilation on NIPPV mode in early stage of multiple injury patients with ALI/ARDS not only has same effect as using IMV
but also can reduce complications and improve patients’ comfortableness.
多发伤急性肺损伤/急性呼吸窘迫综合征无创正压通气
Multiple injuryAcute lung injury/acute respiratory distress syndromenoninvasive positive pressure ventilation
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