无创正压通气成功治疗中重度肺性脑病16例分析

The analysis of the successfully use of NIPPV for sixteen patients with moderate or severe hypercapnic coma

目的:比较中重度肺性脑病患者在应用无创正压通气(NIPPV)后APACHE-Ⅱ评分、格拉斯哥昏迷评分(GCS)、二氧化碳水平、pH与治疗成功的关系。方法:总结应用NIPPV治疗的23例中重度肺性脑病患者资料。结果:16例患者避免了有创通气治疗,各项生理指标于治疗2 h后改善。结论:1.最初几个小时的治疗效果及患者对NIPPV的耐受性可以决定NIPPV治疗的成败;2.NIPPV治疗前血气分析结果及APACHE-Ⅱ评分和GCS并不能预测NIPPV效果。

Objective： To compare the correlations between the effect of the Non-Invasive Positive Pressure Ventilation （NIPPV） treatment and APACHE-Ⅱ score, Glasgow Coma Score （GCS）, level of PaCO2, pH of the patients with moderate or severe hypercapnic coma. Method：The use of NIPPV for twenty-three patients with moderate or severe hypercapnic coma was summarized. Result： Sixteen patients avoid Invasive Positive Pressure Ventilation （IPPV） treatment, the improvement of clinical status parameters occurred after 2 hours. Conclusion： 1. Whether NIPPV will be successfully used depend on the result of initial several hours treatment and the tolerance of the patients to NIPPV.2. The result of arterial blood gas analysis, APACHE- Ⅱ and GCS before NIPPV treatment can＇t predict the effect of NIPPV.