双水平气道正压通气在重症甲型H1N1流感病毒肺炎合并急性呼吸衰竭的应用

Application of Bi-level positive airway pressure in patients with severe pneumonia associated with influenza A H1N1 influenza virus of acute respiratory failure

目的研究无创双水平气道正压通气（BiPAP）对重症甲型H1N1流感病毒肺炎所致急性呼吸衰竭的治疗效果，评估BiPAP在重症甲型H1N1流感病毒肺炎合并急性呼吸衰竭治疗中的作用。方法在常规治疗的基础上采用BiPAP呼吸机经面罩气道正压通气治疗重症甲型H1N1流感病毒肺炎所致急性呼吸衰竭患者18例。观察治疗效果。结果治疗前后PaO2和氧合指数分别为（52±10）mm、（88±9）mmHg和（110±30）mmHg、（200±28）mmHg（P〈0．05）。气管插管率25．0％（6／24），病死率8．3％（2／24）。结论用BiPAP呼吸机经面罩气道正压通气治疗重症甲型H1N1流感病毒肺炎所致急性呼吸衰竭，减少了气管插管率，在抢救治疗中疗效肯定，有重要的应用价值。

Objective To evaluate the （BiPAP） ventilation on the severe influenza A effect of noninvasive Bi-level positive airway pressure virus associated with pneumonia and acute respiratory {ailure （ARF）. Methods Based on conventional therapy,18 patients with acute respiratory failure caused by severe pneumonia associated with influenza A H1N1 were treated by BiPAP via face mask. The therapeutic effects were observed and evaluated. Results PaO2 and PaO2/FiO2 before and after treatment were （52±10） mm Hg, （88±9） mm Hg and （110±30） mm Hg, （200±28） mm Hg, respectively （ P 〈 0.05）. Endotracheal intubation rate was 25.0% （6/24） and case fatality rate was 8.3%（2/24）. Conclusions BiPAP by face mask can reduce the rate of endotracheal intubation in the treatment of severe pneumonia caused by influenza A （H1N1） virus in acute respiratory failure. It could be an effective approach in the emergency treatment with clinical value.