BiPAP呼吸机在神经肌肉疾病出现呼吸衰竭中的早期应用

Early Application of BiPAP Ventilator to Neu romuscular Disorders for Patients with Acute Respiratory Failure

目的评价早期应用BiPAP呼吸机无创正压通气(NIPPV)对神经肌肉疾病出现急性呼吸衰竭的治疗效果。方法在常规治疗的基础上早期采用BiPAP呼吸机NIPPV治疗神经肌肉疾病出现的呼吸衰竭患者25例,并比较NIPPV治疗前后动脉血气、呼吸频率、心率的变化及转归。结果用BiiPAP呼吸机NIPPV治疗1h后,患者动脉血氧饱和度(SaO2)和动脉血氧分压(PaO2)上升,心率(HR)减漫(P<0·05);48h及72h后PaO2,SaO2,HR,呼吸频率(RR)持续好转(P<0·05)。21例治疗有效,4例治疗失败需有创通气,总有效率84%(21/25)。采用NIPPV治疗出现并发症8例。结论用BiPAP呼吸机NIPPV治疗神经肌肉疾病早期的呼吸衰竭疗效明显,减少了气管插管给患者带来的痛苦。

Objective To evaluate the treatment outcome of early application of noninvasive positive pressure ventilation （NIPPV） in the patients of neuromuscular disorders with acute respuatory failure. Methods NIPPV with BiPAP ventitators was applied to 25 cases of neuromusclar disorders with acute respiratory failure on the basis of routine therapy at early stage. Blood gas analysis （ pH, PaO2 , SaO2 , PaCO2 ） was carried out, and heart rate （HR） and respiratory rate （RR） were observed before and after NIPPV. Resuits One hour after NIPPV, there were significant changes in SaO2 , PaO2 , and HR, when compared with those before NIPPV and 48 or 72 hours after NIPPV （P 〈 0.05 ）. There were continuous improvements in SaO2 , PaO2, HR and RR, when compared with those before NIPPV （P 〈0. 01 ）. Twenty-one patients were treated effectively, and four patients needed to be given invasive ventilation. The complications with NIPPV occurred in seven patients. Conclusion NIPPV with BiPAP ventilator was an effective method to the treatment of acute respiratory failure in the patients of neuromusclar disorders. It can reduce the sufferings from endotracheal intubation.