无创机械通气治疗急性呼吸衰竭失败原因分析

Analysis on relevant losing factors of noninvasive positive pressure ventilation in the patients with acute respiratory failure

目的:研究无创正压机械通气(NPPV)治疗急性呼吸衰竭(ARF)失败的相关因素。方法:将60例由各种病因导致ARF并且应用NPPV治疗的患者按照治疗结果分为NPPV失败组和NPPV成功组,比较两组患者病因、年龄、动脉血气分析情况,分析与NPPV治疗失败相关的因素。结果:NPPV失败组36例(60%),NPPV成功组24例(40%)。行NPPV治疗初期NPPV失败组呼吸指数较高,与NPPV成功组比较差异有显著性(P<0.05)。慢性阻塞性肺疾病急性发作、急性心源性肺水肿所致的ARF应用NPPV的成功率较高,重症肺炎和肺间质疾病所致的ARF应用NPPV的成功率较低。结论:ARF患者肺换气功能障碍的严重程度是NPPV治疗成功与否的相关因素。

Objective：To study the losing factors associated with development of noninvasive positive pressure ventilation（NPPV） failure in patients with acute respiratory failure（ARF）.Methods：Sixty patients with ARF resulted from variant diseases were investigated and divided into NPPV failure group and NPPV success group.Comparing reasons,age,blood gas etc factors of the two groups,and analysed related factors of falied group.Results：NPPV failed group 36 cases（60%）,successful group 24 cases（40%）.At Initial stage of NPPV treatment,breath index elevated,which showed significant diference between the two groups（P〈0.05）.NPPV treated acute exacerbation of chronic obstructive pulmonary disease,acute cardiogenic pulmonary edema casued ARF indicated high success rate,severe pulmonary and interstitial lung disease caused ARF showed low successful rate.Conclusion：Severity of pulmonary ventilationary function of ARF patients was a related factor of NPPV successful treatment.