无创正压机械通气治疗重度急性有机氟中毒的临床研究

Clinical research on the treatment of noninvasive positive pressure ventilation on severe acute organofluorine poisoning

目的评价无创正压机械通气治疗重度急性有机氟中毒的临床应用价值。方法急性重度有机氟中毒患者9例,在应用糖皮质激素、俯卧位通气等治疗基础上应用无创正压机械通气;记录治疗期间患者的血PH值、心率(HR)、呼吸频率(RR)、动脉血;氧合指数(PaO2/FIO2)及并发症。结果 9例患者中好转8例,1例病情加重改有创通气,10天后死亡;8例好转患者治疗后的心率、呼吸频率明显下降,动脉血氧合指数上升,与治疗前比较差异有统计学意义(P<0.05)。结论无创正压机械通气能有效缓解重度急性有机氟中毒患者症状,改善低氧。

Objective To evaluate the clinical value of noninvasive positive pressure ventilation （NPPV） treatment for severe acute organofluorinc poisoning. Methods 9 patients with severe acute organofluorine poisoning were given routine treatment such as glu- cocorticoid and prone position plus noninvasive positive pressure ventilation. The clinical data during treatments period were reviewed, which included PH value of blood, heart rate, respiratory rate, arterial blood, oxygenation index, and the complications. Results 8 patients got better after the treatment and one patient got worse, who were given additionally invasive ventilation and died 10 days after. The difference of patients＇ RR, HR and oxygenation index before and after the treatment showed statistical significance （ P 〈 0. 05 ）. Conclusion NPPV treatment for severe acute organofluorine poisoning can relieve the clinic symptom and improve hypoxemia.