无创双水平正压通气联合痰液引流在重症肺炎患者中的治疗研究

Effect of noninvasive bilevel positive airway pressure ventilation combined sputum aspiration in patients with severe pneumonia

目的:研究无创双水平正压通气(BiPAP)联合痰液引流在重症肺炎患者中的治疗效果。方法:62例重症肺炎患者分为A、B两组,A组32例患者采用无创双水平正压通气联合气管内留置吸痰管吸痰进行治疗,B组30例患者给予单纯的无创双水平正压通气治疗,观察两组的治疗效果。结果:两组患者无创通气治疗1h后氧合均得到明显改善;A组患者呼吸支持时间为(86.8±36.7)h,明显少于B组的(164.4±77.5)h;A组患者住院时间为(14.9±7.7)d,明显少于B组的(22.1±10.8)d;A组气管插管率为18.8%,明显少于B组的43.3%;A组、B组死亡率分别为15.6%、23.3%,两组患者在死亡率方面差异无统计学意义。A组、B组患者呼吸治疗相关的并发症发生率分别为25%、26.7%,两组患者呼吸治疗相关的并发症发生率比较差异无统计学意义。结论:对于重症肺炎患者来说,可以考虑应用无创正压通气联合气管内留置吸痰管吸痰进行治疗。

Objective：To study the effect of noninvasive bilevel positive airway pressure （BiPAP） ventilation combined sputum aspiration in patients with severe pneumonia. Method： 62 patients with severe pneumonia were di-vided into group A（32 cases） and group B（30 cases）. The patients in group A were received noninvasive BiPAP ventilation and endotracheal detaining suction catheter for sputum aspiration. The patients in group B were treated with BiPAP ventilation only. Result：After BiPAP ventilation,the oxygenation improved significantly in both group A and group g. The patients in group A had a significantly shorter duration of respiratory support than group B （86.8±36.7 versus 164.4±77.5 hours,P〈0.01）. The hospital stay of group A was shorter than that of group B （14.9±7.7 versus 22.1±10.8 days,P〈0.01）. The rate of endotracheal intubation of group A was significantly lower than that of group B （18.8% versus 43%,P〈0.05）. No significant difference was found in the mortality rates of these two groups. No significant difference was found in the complication rates of these two groups during respiratory support. Conclusion： Noninvasive BiPAP ventilation combined endotracheal detaining suction catheter for sputum aspiration can be used to treat patients with severe pneumonia.