经鼻压力支持通气治疗Ⅱ型呼吸衰竭(对可允许高碳酸血症通气治疗的初探)

Monagemeut of Respiratory Failure Through Nasal Mask Pressare Support Ventilation (Primary Study of Permissive Hypercapnia Ventilation)

探讨经鼻压力支持通气(PSV)治疗Ⅱ型呼衰的效果及对可允许高碳酸血症通气(PHV)治疗的指导意义。采用BiPAP通气机治疗Ⅱ型呼衰20例,CPAP通气机治疗2例,疗程3～8天。结果对比治疗前后血气示:pH 7.345±0.085到7.385±0.068(P>0.05);PaO_2 50.34±17.50mmHg到74.12±16.58mmHg(P<0.001);PaCO_2从67.63±25.40mmHg到54.02±18.92mmHg(P<0.001);死亡4/22例(19.2%),同期气管插管通气Ⅱ型呼衰死亡21/22例(95.5%)。结果提示PSV经鼻通气治疗Ⅱ型呼衰安全有效,PHV对Ⅱ型呼衰的治疗同样具有指导意义。

To Study management of respiratory failure tape I through nasal mask pressure support Ventilation (PSV) and guiding signif cation by concepts of permissive hypercapnia ventilation (PHV). Method 22 patients with respiratory failure tape I using Bipap of 20 pitients and CPAP for 2 Patients for 3 to 8 days ,To compare the resalts of bleed gas anlysis before and after managements. Result pH 7. 345 ± 0. 085 to 7. 385 ± 0. 068( P >0. 05);PaO2 50. 34 ± 17. 50mmHg to 74. 12 ± 16. 58mmHg( P <0. 001);PaCO2 67. 63 ± 25. 40mmHg to 54. 02 ± 18. 92mmHg ( P <0. 001) respective,mortality 19. 2% (4/22cases) ,In the same periods,the mertoli-ty of managemet of respiratory failure tape Ⅱ by tracheal intubate was 95. 5% (21/22cases). Conclusion Through nasl mask PSV was safe and effertive for patients with respiratony failure tape Ⅱ . The concepts of PHV for guiding clinical management was signi ficance.