无创通气治疗急性呼吸衰竭的临床疗效观察

The Clinical Outcome of Noninvasive Ventilation in Acute Respiratory Failure

目的:探讨手术后和急性心源性肺水肿所致急性呼吸衰竭患者应用双水平气道正压(BiPAP)无创呼吸机辅助通气后的临床疗效.方法:对36例上述患者在常规治疗无效时加用BiPAP辅助通气,检测应用前后的血压、心率、呼吸与动脉血气等参数,观察其疗效.结果:3例因无创通气效果不佳,而改用气管插管.33例经加用BiPAP辅助通气治疗后血压、心率与SaO2等均有明显改善.应用12～36h后.述参数逐步改善直至恢复正常,持续应用时间为4～26d.病情缓解且稳定持续48h以上者可考虑逐步撤除呼吸机.结论:手术后和急性心源性肺水肿所致急性呼吸衰竭患者加用BiPAP呼吸机治疗可有效改善患者的呼吸状态,促进呼吸、循环系统功能的恢复.

Objective:To investigate the clinical outcome of acute respiratory failure after using noninvasive ventilation.Method:Thirty-six patients refractory to conventional medical therapy were applied with noninvasive mechanical ventilation by BiPAP respirator.Hemodynamic status,respiration and artery blood gas were measured before and post using respirator.Result:Three patients were changed to intubation because of no improvement by noninvasive ventilation.33 cases were improved in symptom,blood pressure,heart rate and SaO2 significantly after using BiPAP ventilation.Most of them were improved 12～36h later after using BiPAP.BiPAP ventilation were removed gradually when clinical status and above parameters were improved markedly or became norma1.Conclusion:Acute respiratory failure treated with noninvasive BiPAP ventilation may improve clinical symptoms.