紧急机械通气用于急诊呼吸衰竭患者中的临床效果

Clinical efficacy of emergency mechanical ventilation in patients with respiratory failure

目的探索紧急机械通气治疗急诊呼吸衰竭患者的疗效。方法于2015年5月~2017年5月来我院急诊科就诊的呼吸衰竭患者中选出43例为研究对象,根据患者的机械通气方式不同分组,有创组患者给予紧急的有创正压通气治疗,无创组患者给予紧急的无创正压通气治疗,对比两组患者的抢救效果。结果有创组患者的死亡率0.00低于无创组患者的20.0%,P<0.05;有创组存活患者在治疗2h的PaCO_2低于无创组,且PaO_2高于无创组,P<0.01;在治疗24h,两组存活患者的血气分析指标差异不大,P>0.05;两组存活患者的机械通气时间、住院时间差异无统计学意义,P>0.05。结论在急诊呼吸衰竭患者治疗中有创机械通气可以快速缓解患者的血气分析指标;无创机械通气避免了插管造成的创伤,但是对血气指标的改善相对缓慢,对于病情严重的患者应紧急选择有创机械通气,对于病情轻微的患者优先选择无创机械通气,改善预后。

Objective To investigate the efficacy of emergency mechanical ventilation in the treatment of emergency respiratory failure.Methods The patients with respiratory failure in our hospital from May 2015 to May 2017 to the emergency department of our hospital in 43 cases were selected as the research object,according to the mechanical ventilation patients in different groups,a group of patients treated with noninvasive positive pressure ventilation treatment is urgent,noninvasive groups of patients were given emergency noninvasive positive pressure ventilation treatment,contrast two groups of patients rescue effect.Results There was a group of patients with a mortality rate of 0.00 was significantly lower than that of non invasive group were 20%,P〈0.05;invasive group survival of patients was significantly lower than that in the noninvasive group in the treatment of 2 h,PaCO2,and PaO2 was higher than that of non invasive group,P〈0.01;in the treatment of 24 h,blood gas analysis index of survival of patients with two groups of difference is not big,P〉0.05;mechanical ventilation time,hospitalization time difference between the two groups of patient survival were not significant,P〉0.05.Conclusion In the treatment of respiratory failure in emergency patients with invasive mechanical ventilation can quickly relieve the blood gas analysis index;noninvasive ventilation to avoid intubation caused by trauma,but to improve the index of blood gas is relatively slow,for seriously ill patients should choose emergency invasive mechanical ventilation for mild patients preferred noninvasive mechanical ventilation,improve the prognosis.