补阳还五汤联合无创通气对重症肺炎撤机的疗效观察

Curative Effect Observation of Buyang Huanwu Decoction combined with Noninvasive Ventilation for Severe Pneumonia Weaning Patients

目的分析探讨在重症肺炎机械通气的治疗中,采用补阳还五汤与无创通气联合治疗的方式取得的临床效果。方法选取我院2013年1月—2015年1月收治的重症肺炎需机械通气的患者101例,随机分为对照组(49例,无创通气治疗)和试验组(52例,补阳还五汤与无创通气联合治疗)。比较两组患者撤机后HR、R、Pa CO2、氧合指数的变化及插管率、机械通气时间及ICU住院时间。结果治疗组撤机后呼吸频率及心率变化不大,对照组呼吸及心率增加10%左右,对二氧化碳分压和氧合指数影响两组无差别,试验组患者ICU住院时间(27.64±4.39)天、机械通气时间(10.96±3.37)天明显短于对照组患者ICU住院时间(34.38±7.16)天、机械通气时间(15.57±4.05)天,试验组患者插管率(3.80%)明显低于对照组患者插管率(30.60%),有统计学意义(P<0.05)。结论治疗组撤机后呼吸频率及心率变化不大,对照组呼吸及心率增加10%左右,对二氧化碳分压影响两组无差别,插管率治疗组下降,无创通气时间治疗组明显缩短,患者的满意程度较好,值得临床上大力推广使用。

Objective To discuss and analyze the curative effect of Buyang Huanwu decoction combined with noninvasive ventilation in the severe pneumonia weaning treatment. Methods Selecting 101 cases of patients with severe pneumonia needed mechanical ventilation, which admitted in our hospital from January 2013 to January 2015, they were divided into the experimental group （49 cases used noninva- sive ventilation treatment） and control group （52 cases used Buyang Huanwu decoction combined with noninvasive Ventilation）. After weaning HR, R, PaCO2, oxygenation index change, the rate of intubation mechanical ventilation time and ICU length of hospital stay of the two groups were compared. Results After weaning, the respiratory rate and heart rate of the experimental group changed little. The respi- ratory rate and heart rate of the control group increased about 10%. There was no difference in partial pressure of carbon dioxide and oxy- genation index of the two groups. The ICU length of hospital stay and mechanical ventilation time of the experimental group was （27.64 ＋ 4.39） day and （10.96 ~： 3.37） days, respectively, which was significantly shorter than （34.38 ＋ 7.16） day and （15.57 ＋ 4.05） days of the control group, respectively. The intubation rate of the experimental group was 3.80% which was significantly lower than 30.60% of the control group, and the difference was significant statistically significant （P〈0.05）. Conclusion After weaning, the respiratory rate and heart rate of the experimental group changed little. The respiratory rate and heart rate of the control group increased about 10%. There was no difference in partial pressure of carbon dioxide of the two groups. The intubation rate of the experimental group decreased, the noninvasive ventilation of the experimental group was significantly shortened, and patients＇ satisfaction was better. It is worth promoting clinical use.