无创呼吸机辅助通气在心脏术后继发低氧血症患者中的效果观察

Noninvasive ventilator assisted ventilation in cardiac patients with postoperative secondary hypoxemia in curative effect evaluation and application of nursing

目的探讨无创呼吸机辅助通气(NIPPV)和气管插管呼吸机辅助通气两种通气方式对心脏术后已拔除气管插管又出现低氧血症患者中的疗效及护理。方法分析我科2010年7月至2012年7月心脏术后27例拔气管插管后出现低氧血症而直接行气管插管呼吸机辅助呼吸,与2012年8月至2014年8月心脏术后27例拔气管插管后出现低氧血症,行无创呼吸机辅助通气两者疗效的对比。结果无创通气有效率为66.67%,气管插管呼吸机辅助通气有效率为70.37%,疗效上无统计学差异(P>0.05)。结论无创呼吸机辅助通气减少二次插管,在气道损伤和呼吸道感染上明显优于气管插管呼吸机辅助通气,无创呼吸机辅助通气具有低损伤、痛苦少、不增加呼吸道感染风险、具有良好的耐受性以及治疗护理效果满意。

Objective Noninvasive ventilator assisted ventilation（ NIPPV） and trachea intubation respirator assisted ventilation in two ventilation modes for the heart surgery has been pulling endotracheal intubation and the curative effect and nursing in patients with hypoxemia. Methods Analysis of our department in July 2010 - July 2012 heart of 27 cases of postoperative hypoxemia after tracheal intubation and pull straight line endotracheal intubation auxiliary breathing machine,and from August 2012 - August 2014 heart of 27 cases of postoperative hypoxemia after endotracheal intubation,pull line noninvasive ventilator assisted ventilation both curative effect comparison. Results Noninvasive ventilation effective rate was 66. 67%,endotracheal intubation respirator assisted ventilation effective rate was 70. 37%,there is no statistical difference of curative effect（ P〉 0. 05）. Conclusions Noninvasive ventilator assisted ventilation to reduce secondary intubation,and respiratory infections in airway damage on endotracheal intubation is obviously better than the respirator assisted ventilation,noninvasive ventilator assisted ventilation with low damage,less pain,not increase the risk of respiratory infections,good tolerance and care effect.