BiPAP治疗重症社区获得性肺炎致呼吸衰竭合并高乳酸血症临床疗效分析

Clinic analysis of Bi-level positive airway pressure ventilation in the treatment of severe community acquired pneumonia patients complicated with respiratory failure and hyperlactacidemia

目的:观察双水平无创正压通气(BiPAP)治疗重症社区获得性肺炎致呼吸衰竭合并高乳酸血症的临床疗效。方法:选择符合重症社区获得性肺炎诊断标准并且合并呼吸衰竭、高乳酸血症的患者79例,随机分成无创组41例及有创组38例。结果:治疗2h后,两组患者动脉血气、呼吸频率、血乳酸、心率、指脉氧饱和度等指标均有显著改善(P<0.05),但整个疗程无创组的病死率、住院时间及医疗费用明显减少(P<0.05)。结论:重症社区获得性肺炎致呼吸衰竭合并高乳酸血症患者早期使用BiPAP能迅速降低患者的二氧化碳蓄积,改善缺氧,降低血乳酸水平,缩短住院时间,降低医疗费用,提高救治成功率。

Objective:To observe the effect of Bi-level positive airway pressure ventilation in the treatment of severe community acquired pneumonia patients complicated with respiratory failure and hyperlactacidemia.Method:Seventy-nine patients,who had been diagnosed as SCAP complicated with respiratory failure and the level of blood lactic acid was higher than 2mmol/L,were randomly divided into the BiPAP group(n=41)and the control group(n =38).Result:Two hours after the treatment,the result of blood gas analysis,breathing rate,heart rate, level of lactic acid,clinical symptoms and oxygen saturation were both significantly improvedin the BiPAP group and the control group(P<0.05).However,length of hospital stay,low mortality rate and hospitalization fee were more pronounced in the BiPAP group than in the control group(P<0.05).Conclusion:The early use of BiPAP can reduce carbon dioxide accumulation,lower blood lactate levels,improve tissue oxygenation,shorten the time of hospitalization,reduced hospitalization expenses and improve treatment success rate in the treatment of SCAP patients complicated with respiratory failure and hyperlactacidemia.