无创双水平气道正压通气治疗重症社区获得性肺炎疗效分析

Analysis of therapeutic effect of bilevel positive airway pressure in the treatment of severe community acquired pneumonia

目的探讨无创双水平气道正压通气（Bi PAP）治疗重症社区获得性肺炎的临床疗效。方法分析我院自2012年1月∽2014年1月收治的82例SCAP患者,82例患者随机分为治疗组（42例）与对照组（40例）。对照组给予常规治疗,包括抗感染,祛痰,抗休克,扩张支气管,维持水电解质酸碱平衡以及营养支持。治疗组在对照组的基础上,给予无创双水平气道正压通气治疗。观察两组患者的临床疗效、气血水平以及临床症状。结果对照组与治疗组临床总有效率分别为82.50%（33/40）、95.24%（40/42）,两组比较差异且有统计学意义（P〈0.05）;两组术后Pa O2、Pa CO2,Sa O2水平比较有统计学差异（P〈0.05）,PH水平比较无统计学差异（P〉0.05）;治疗后治疗组在咳嗽、发热、肺部啰音、白细胞计数方面,显著低于对照组,两组比较有统计学意义（P〈0.05）。结论无创双水平气道正压通气治疗SCAP,可以提高临床总有效率,有效改善临床症状及气血水平,有临床推广应用的价值。

Objective To investigate the clinical curative effect of Bilevel positive airway pressure （BiPAP） in the treatment of severe community acquired pneumonia （SCAP）.Methods82 cases of SCAP patients in our hospital from 2012 January to 2014 January were analyzed and randomly divided into treatment group （42 cases） and control group （40 cases）. The control group received conventional therapy, including anti infection, eliminating phlegm, anti shock, bronchiectasis, maintenance the balance of fluid, electrolytes and acid-base, nutritional support. The treatment group was given BiPAP based on the treatment in control group. The clinical curative effect, the blood level and the clinical symptoms of two groups of patients were observed.ResultsThe total clinical effective rates in two groups were 82.50% （33/40）, 95.24% （40/42）,there was statistically significant （P〈0.05）;The levels of PaO2, PaCO2, SaO2 after operation were statistically significant （P〈0.05）.The PH level showed no statistical significance （P〉0.05）; The cough, fever, pulmonary rales and white blood cell count in the treatment group after treatment were significantly lower than the control group, there were statistically significant （P〈0.05）.Conclusion BiPAP in the treatment of SCAP, can improve the total clinical efficiency, effectively improve the clinical symptoms and blood level, has clinical application value.