无创机械通气治疗肺性脑病昏迷患者疗效分析

Therapeutic effect of noninvasive mechanical ventilation on patients with pulmonary encephalopathy

目的探讨无创机械通气治疗肺性脑病昏迷患者的有效性和安全性。方法回顾性分析2015年7月~2018年6月我院收治的采用无创机械通气治疗的肺性脑病昏迷患者17例,评估患者意识状态、血气分析及并发症情况。结果通气治疗12 h、24 h、48 h后意识状态改变差异均有统计学意义(P<0.05);通气后24 h、48 h的p H值与通气前比较差异均有统计学意义(P<0.05);通气后4 h、12 h、24 h、48 h的PaCO2值与通气前比较差异均有统计学意义(P<0.05);通气后12 h、24 h、48 h的PaO2与通气前相比明显好转(P<0.05);治疗后面部压迫部位皮肤潮红及破溃7例,胃胀气5例,恶心2例,呕吐1例,呼吸机相关性肺炎1例,谵妄3例。结论肺性脑病昏迷患者进行无创机械通气治疗,疗效确切,并发症轻微。

Objective To explore the efficacy and safety of noninvasive mechanical ventilation in the treatment of comatose patients with pulmonary encephalopathy. Methods 17 cases of comatose patients with pulmonary encephalopathy who underwent noninvasive mechanical ventilation in our hospital from July 2015 to June 2018 were retrospectively analyzed. The state of consciousness, blood gas analysis and complications were assessed. Results There were significant differences in the changes of consciousness status after ventilation treatment for 12 h, 24 h and 48 h(P <0.05).There were significant differences in p H between 24 h and 48 h after ventilation and before ventilation(P<0.05). There were significant differences in PaCO2 between 4 h, 12 h, 24 and 48 h after ventilation and before ventilation(P<0.05).PaO2 at 12 h, 24 h, 48 h after ventilation was significantly improved than that before non-invasive ventilation(P<0.05).There were 7 cases of flushing and rupture in the facial compression site, 5 cases of bloating, 2 cases of nausea, 1 case of vomiting, 1 case of ventilator-associated pneumonia, and 3 cases of delirium after treatment. Conclusion Non-invasive ventilation in the treatment of comatose patients with pulmonary encephalopathy has definite curative effect and mild complications.