有创-无创序贯机械通气治疗有机磷杀虫药中毒并发呼吸衰竭28例

Sequential Invasive to Noninvasive Mechanical Ventilation in Treatment of Organophosphorus Insecticides Poisoning with Respiratory Failure:Report of 28 Cases

目的:通过对比研究评价有创-无创序贯机械通气治疗有机磷杀虫药中毒并发呼吸衰竭的优越性。方法:将64例患者分为两组:有创机械通气治疗组(n=36)和有创-无创序贯机械通气治疗组(n=28)。主要观察指标为:呼吸机相关性肺炎发生率、有创机械通气时间、总机械通气时间、总住院时间、再插管率及住院病死率。结果:两组间比较呼吸机相关性肺炎发生率、有创机械通气时间、总机械通气时间、总住院时间及再插管率,有创-无创序贯机械通气治疗组明显低于对照组,组间比较差异显著,有统计学意义(P<0.05)。住院病死率两组间差异无统计学意义(P>0.05)。结论:有创-无创序贯机械通气治疗有机磷杀虫药中毒并发呼吸衰竭疗效肯定且安全可靠,值得在临床推广应用。

Objective：To evaluate the therapeutic effects of sequential invasive to noninvasive ventilation for organophosphorus insecticides poisoning complicated with respiratory failure.Methods：The studied cases were assigned to two groups：invasive ventilation group（n=36）and sequential invasive to noninvasive ventilation group（n=28）.The main clinical parameters observed were： incidence of ventilator-associated pneumonia（VAP）,the invasive ventilation period,total ventilation period,total hospital stay,reintubation rate and in-hospital mortality.Results：The incidence of VAP,the invasive ventilation period,total ventilation period,total hospital stay and reintubation rate of the cases with sequential invasive to noninvasive ventilation group were significantly lower than those in invasive ventilation group（P0.05）.There was no significantly difference between the two groups in the in-hospital mortality（P0.05）.Conclusion：Sequential invasive to noninvasive mechanical ventilation for treatment of organophosphorus insecticides poisoning complicated with respiratory failure can achieve good clinical efficacy and safety,and worthy of further promotion.