肾移植术后合并急性呼吸窘迫综合征患者的无创通气治疗

Non-invasive ventilation treatment for patients with adult respiratory distress syndrome following kidney tranplantation

目的评价双水平气道正压(BiPAP)无创通气对肾移植术后合并ARDS患者的临床应用价值。方法对20例肾移植术后合并ARDS患者采用BiPAP呼吸机经鼻面罩双水平正压通气治疗,监测通气前后患者生命体征(呼吸、心率、血压)及动脉血气(pH、PaO2、PaCO2、SaO2)的变化,并观察其临床疗效。结果18例患者经无创通气治疗后生命体征及动脉血气指标改善,无创通气治疗降低患者的血压、呼吸、心率及血PaCO2水平,提高了血pH、PaO2、SaO2水平,治疗前后组间有显著差异(P<0.05)。结论肾移植术后合并ARDS患者病情重,进展快,BiPAP无创通气能迅速改善患者临床症状和低氧血症,是一种安全有效的治疗方法。

Objective To evaluate the clinical significance of non-invasive Bi-level positive airway pressure (BiPAP) ventilation for patients with adult respiratory distress syndrome(ARDS) following kidney transplantion.Methods 20 patients with ARDS following kidney tranplantation were treated with nasal BiPAP non-invasive ventilation.The changes of life signs such as respiratory rate (RR)、heart rate (HR) and blood pressure(BP) as well as arterial blood gas (pH、PaO_2、PaCO_2、SaO_2) were recorded and analyzed.Results After BiPAP non-invasive ventilation,the life signs and arterial blood gas (pH、PaO_2、PaCO_2、SaO_2) in 18 patients had been improved significantly.Moreover,their RR、HR、 BP、PaCO_2 decreased significantly,and the levels of pH、PaO_2、SaO_2 increased significantly (P<0.05),compared with those before BiPAP non-invasive ventilation.Conclusions ARDS following kidney transplantion patients are severe and developes fastly,and BiPAP non-invasive ventilation could improve symptoms and hypoxia in patients with ARDS following kidney transplantion.It is also a safe and effective method in treating pneumonia following kidney transplantion.