无创间歇正压通气治疗尘肺并发呼吸衰竭的疗效观察

Clinical value of noninvasive intermittent positive-pressure ventilation in pneumonoconiosis combined with respiratory failure

目的 探讨无创间歇正压通气（NIPPV）治疗尘肺并发呼吸衰竭的疗效.方法 将46例尘肺并发呼吸衰竭患者随机分为治疗组26例和对照组20例.对照组采用常规治疗方法,治疗组在常规治疗的基础上,联合NIPPV治疗,比较两组患者治疗后心率、呼吸频率和PH、二氧化碳分压（PaCO2）、氧分压（PaO2）的变化.结果 治疗组治疗有效率为88.5%（23/26）,对照组为60%（12/20）,两组治疗有效率的差异有统计学意义（P＜0.05）;治疗后治疗组患者心率为（95.38±10.75）次/min,较对照组[（103.00±12.56）次/min]下降;治疗组呼吸频率[（21.69±1.37）：次/min]较对照组[（22.60±1.57）次/min]减慢;治疗组PaCO2[（52.88±10.75）mmHg]比对照组[（59.66±11.49）mm Hg]降低;治疗组PaO2[（100.77±25.3）mm Hg]较对照组[（71.82±17.94 mm Hg]明显升高;两组比较,差异均有统计学意义（P＜0.05）.结论 NIPPV对治疗尘肺并发呼吸衰竭患者有效,可提高治疗有效率,改善动脉血PaO2和PaCO2.

Objective To evaluate the value of noninvasive intermittent positive-pressure ventilation （NIPPV） in treatment of patients with pneumonoconiosis combined with respiratory failure. Method There were 46 inpatients with pneumonoconiosis combined with respiratory failure. Tetwenty-six inpatients treated with conventional therapy and NIPPV were categorized as treatment group; Tetwenty inpatients just treated by conventional therapy served as control group. Compared with the changes of HR、RR and arterial blood gas index （PH、PaCO2、PaO2） in two groups after treatment. Results The effective ratio of treatment group was 88.5%, control group was 60%, which had significant difference （P＜0.05）; The HR in treatment group after treatment was（95.38±10.75）beats per minute, control group was [（103.00±12.56）beats per minute; The RR in treatment group was （21.69±1.37） breaths per minute, control group was [（22.60± 1.57）breaths per minute];The PaCO2 in treatment group was （52.88±10.75）mm Hg, control group was [（59.66± 11.49）mm Hg];All of those were significantly decreased than those in control group （P＜0.05）. The PaO2 in treatment group was （100.77±25.3）mm Hg, control group was [（71.82±17.94） mmHg];Compared with the control group, PaO2 in the treatment group increased significantly （P＜0.05）. Conclusion NIPPV is beneficial to pneumonoconiosis combined with respiratory failure in different degrees.