丙泊酚浅镇静在Ⅰ型和Ⅱ型呼吸衰竭患者无创通气中的效果分析

Analysis of the Effect of Propofol Shallow Sedation in Non-invasive Ventilation of Patients with Type Ⅰ and Type Ⅱ Respiratory Failure

目的探究丙泊酚浅镇静在I型和II型呼吸衰竭患者无创通气中的应用效果。方法以2018年12月-2019年12月在该院进行无创通气治疗的96例呼吸衰竭患者为研究对象,分为I型呼吸衰竭患者组和II型呼吸衰竭患者组,每组48例,使用丙泊酚浅镇静辅助无创呼吸机对患者进行治疗,观察治疗前和治疗后6 h和48 h时患者的呼吸频率(RR)、心率(HR)、脉氧饱和度(SpO2)、血氧分压(PaO2)、血二氧化碳分压(PaCO2)、血pH值(pH)、改用有创通气及术后并发症发生情况。结果治疗前,II型呼吸衰竭患者的PaCO2的水平高于I型呼吸衰竭患者,差异有统计学意义(P<0.05);治疗后6 h,I型呼吸衰竭患者的PaO2和SpO2水平高于II型呼吸衰竭患者,差异有统计学意义(P<0.05),PaCO2的水平低于II型呼吸衰竭患者,差异有统计学意义(P<0.05);治疗后48 h,II型呼吸衰竭患者的PaCO2的水平高于I型呼吸衰竭患者,差异有统计学意义(P<0.05),有创通气和呼吸机相关肺炎的发生情况分别为12.50%、16.67%,均多于I型呼吸衰竭患者,比较差异有统计学意义(χ^2=3.852、4.019,P<0.05)。结论丙泊酚浅镇静在I型呼吸衰竭无创通气治疗中的效果优于II型呼吸衰竭患者,术后并发症更少出现,有效减轻患者的负担和痛苦,其为I型和II型呼吸衰竭患者无创通气中的应用提供数据支持。

Objective To explore the effect of propofol shallow sedation in non-invasive ventilation of patients with type I and type II respiratory failure.Methods 96 patients with respiratory failure who underwent non-invasive ventilation treatment in the hospital from December 2018 to December 2019 were divided into type I respiratory failure patient group and type II respiratory failure patient group,with 48 cases in each group.Use propofol light sedation assisted non-invasive ventilator to treat the patient,observe the patient’s respiratory rate(RR),heart rate(HR),pulse oxygen saturation(SpO2),blood oxygen partial pressure before treatment and at 6 h and 48 h after treatment(PaO2),blood carbon dioxide partial pressure(PaCO2),blood pH(pH),switch to invasive ventilation and postoperative complications.Results Before treatment,the PaCO2level of type II respiratory failure patients was higher than that of type I respiratory failure patients,the difference was statistically significant(P<0.05);6 h after treatment,the PaO2and SpO2levels of type I respiratory failure patients were higher than those of type II respiratory failure patients,the difference was statistically significant(P<0.05),the level of PaCO2was lower than that of type II respiratory failure patients,the difference was statistically significant(P<0.05);48 h after treatment,the level of PaCO2of type II respiratory failure patients was higher than that of type I respiratory failure patients,the difference was statistically significant(P<0.05)and the incidence of invasive ventilation and ventilator-associated pneumonia were12.50%and 16.67%,respectively,which were higher than those of patients with type I respiratory failure,and the difference was statistically significant(χ^2=3.852,4.019,P<0.05).Conclusion Propofol shallow sedation is more effective than type II respiratory failure patients in non-invasive ventilation treatment of type I respiratory failure,and there are fewer postoperative complications,which effectively reduces the burden and pain of patients.It is in type I and type II,which provides data support for the application of noninvasive ventilation in patients with respiratory failure.