BiPAP鼻罩式机械通气和气管内插管机械通气在治疗呼吸衰竭中作用的比较

Comparison of The Effect Between BiPAP Nasal Ventilation and Endotracheal Intubation Ventilation in Respiratory Failure

观察了51例呼吸衰竭患者分别应BiPAP鼻罩式机械通气和经鼻气管插管机械通气的疗效,其中BiPAP组22例,经鼻气管插管组29例.两组患者治疗前血气PaO_2和PaCO_2相差不显著,提示病情程度基本相似,治疗后血气PaO_2和PaCO_2改善均十分明显,提示BiPAP除对Ⅰ型呼衰外,对Ⅱ型呼衰的治疗同样有一定疗效,特别适用于需行机械通气而又神志清醒不愿做经鼻气管插管的患者,以及经鼻气管插管行机械通气后血气仍有异常和有呼吸机依赖倾向者,但因BiPAP应用后血气改善和稳定需时相对较长,故对病情极度危重,昏迷或自主呼吸明显减弱者应用时需慎重.

We had observed the curative effect of two kinds of ventilation in 51 patients with respi-ratory failure,22 cases were treated by BiPAP nasal ventilation and 29 cases by endotracheal intubationventilation. There were no differences of PaO2 and PaCO2 between two groups before treatment and thepatient's conditions were also similar in two groups. After treatment the blood gases including PaO2 andPaCO2 were greatly improved in two groups. the results showed that BiPAP nasal ventilation was effec-tive for both type I and type II respiratory failure. It was especially suitable for those patients whoneeded mechanical ventilation but they were fully conseious and reeused endotracheal intubation. It wasalso available to patients who were treated with endotracheal intubation ventilation without and im-provement in blood gases or they were dependent on the mechanical ventilation. Decause BiPAP nasalventilation needs more time for the improvement and stabilization of the blood gases,care must be tak-en for severely ill patients,and patients with coma or patients with significant weakness of spontaneousbreathing.