早期无创机械通气治疗老年重症肺炎的疗效观察

Effect of early non-invasive mechanical ventilation on elderly patients with severe pneumonia

目的观察早期无创机械通气在老年重症肺炎治疗中的疗效。方法选取2008年1月～2010年12月我院收治的老年重症肺炎符合无创机械通气条件60例,比较患者治疗前、治疗6h后的呼吸、心率、PaO_2、PaO_2/FIO_2;上机时间、生存率以及X线胸片对比。结果无创机械通气治疗后患者呼吸窘迫症状缓解,PaO_2、氧合指数明显改善,患者的心率明显下降,呼吸困难减轻,比较治疗前均有显著性差异(P<0.05)。平均上机时间(6±4)d,胸部x线胸片示病灶明显吸收46例,其中8例因治疗效果欠佳改用气管插管行有创机械通气,7例并发多脏器功能障碍死亡。结论对于老年重症肺炎患者早期应用无创通气,可以迅速纠正缺氧,改善临床症状和预后。

Objective To observe the effect of early non- invasive mechanical ventilation on elderly patientswith severe pneumonia. Methods A total of 60 patients from January, 2008 to October, 2010 with severe pneu- monia and receiving non- invasive mechanism ventilation were recruited to participate in this study. Compare the parameters including the respiratory rate, heart rate, PaO2, PaO2/FIO2, the time with ventilation, x - ray of chest and the survival rate of the patients before and 6 hours after ventilation. Results The non - invasive ventilation treatment alleviated the respiratory distress syndrom and improved the value of PaO2, PaO2/FIO2. Heart rate of the patients decreased obviously after the non - invasive ventilation. The difference between was significant. Meantime with ventilation was （6 ± 4） days. The x - ray showed that the effusion was obviously absorbed in 46 patients after ventilation, including 8 patients changing to invasive ventilation treatment because of the negative effect of non - invasive ventilation and 7 patients dying from the mutiple organs dysfunction syndrom. Conclusion The ear- ly non - invasive mechanical ventilation invention could rapidly improve the hypoxemia, the distress syndrom and the prognosis, so it should be advocated widely.