无创性机械通气在治疗肺结核合并呼吸衰竭中的临床疗效

Clinical effect of noninvasive ventilation in the treatment of pulmonary tuberculosis with respiratory failure

目的探讨无创性机械通气在治疗肺结核合并呼吸衰竭中的临床疗效。方法回顾性分析2011年11月-2014年11月黑龙江省传染病防治院收治的76例肺结核合并呼吸衰竭患者的临床资料。患者均给予常规治疗,如抗感染、祛痰,针对基础疾病和并发症治疗。在此基础上实施无创性机械通气治疗。比较患者治疗前后Pa O2、Pa CO2、pH值变化。结果治疗后出现2例患者死于大咯血,4例患者因经济原因放弃治疗,其他患者均无不良反应,有效率为92.11%。治疗后Pa O2和PEF明显升高,Pa CO2明显下降,pH值趋近正常,较治疗前明显改善,差异有统计学意义（P〈0.05）。结论无创性机械通气在治疗肺结核合并呼吸衰竭中疗效满意,安全,无明显并发症,易于患者接受。

Objective To explore the clinical efficacy of noninvasive ventilation in the treatment of pulmonary tuberculosis with respiratory failure. Methods The clinical data of 76 patients with pulmonary tuberculosis with respiratory failure,who were in hospital from November 2011 to November 2014,were retrospectively analyzed.All patients were given conventional treatment, such as anti infection, eliminating phlegm,for the treatment of underlying diseases and complications.On the basis,patients were given noninvasive mechanical ventilation treatment.Pa O2,Pa CO2,and p H were compared before and after treatment. Results After treatment,2 patients died of massive hemoptysis,4 patients due to economic reasons to give up treatment.Other patients had no adverse reaction,the efficiency was 92.11%.After treatment,Pa O2 and PEF of other patients were significantly elevated,Pa CO2 decreased significantly,and the p H value reaching normal.Observation indexes were compared with those before treatment significantly improved（P〈0.05）. Conclusion Noninvasive ventilation in the treatment of pulmonary tuberculosis complicated with respiratory failure is satisfactory,safe and has no obvious complications,and is easy to be accepted by patients.