无创正压通气在老年胸部外科手术患者拔管后的应用分析

Application of noninvasive positive pressure ventilation after extubation in elderly patients undergoing thoracic surgery

目的总结无创正压通气治疗在胸部手术后老年患者的临床经验。方法选择2015年1月到2017年2月期间收治的30例老年胸部手术患者的临床资料,其中15例患者术后接受常规呼吸治疗(对照组)15例术后给予无创正压通气治疗(观察组),对比两组患者治疗效果。结果观察组患者并发症的发生率13.3%明显小于B组患者的26.7%,差异具有统计学意义(P<0.05);两组患者术后1 d时PaCO2、PaO2、HR、呼吸以及MBP比较没有明显差异(P>0.05),术后3 d两组比较的差异具有统计学意义(P<0.05);观察组患者的机械通气时间、住院时间以及住院费用明显小于对照组(P<0.05);两组患者治疗后的焦虑和抑郁评分比较差异具有统计学意义(P<0.05);观察组患者治疗后的生理职能、情感职能、社会功能、一般健康以及总体健康等生活质量评分明显优于对照组组(P<0.05)。结论老年胸部外科手术后需要采取无创正压通气治疗,有利于患者康复,减少并发症的发生率。

Objective To summarize the clinical experience of noninvasive positive pressure ventilation in elderly patients after thoracic surgery.Methods The clinical data of 30 elderly patients undergoing thoracic surgery from January 2015 to February 2017 were selected.Among them,15 patientsreceived conventional respiratory therapy(group B)and 15 patients received noninvasive positivepressure ventilation(group A)after surgery.The therapeutic effects of the two groups were compared.Results The incidence rate of complications in group a(13.3%)was significantly lower than that ingroup b(26.7%),and the difference was statistically significant(P<0.05).There was no significantdifference in PaCO2,PaO2,HR,respiration and MBP between the two groups at 1 d after operation(P>0.05).The difference between the two groups at 3 d after operation was statistically significant(P<0.05).The hospitalization time and expenses of patients in group a were significantly less than those in group b(P<0.05).There was significant difference in anxiety and depression scores between the two groupsafter treatment(P<0.05).The quality of life scores of patients in group a,including physiologicalfunction,emotional function,social function,general health and general health,were significantlybetter than those in group b(P<0.05).Conclusion Non-invasive positive pressure ventilation is neededafter thoracic surgery in the elderly,which is beneficial to the recovery of patients and reduces theincidence of complications.