无创正压通气在急性呼吸衰竭急诊治疗中的应用

Application of Non-Invasive Positive Pressure Ventilation in Emergency Treatment of Acute Respiratory Failure

目的:探讨无创正压通气在急性呼吸衰竭急诊治疗中的应用价值。方法:选取2017年1月-2020年6月赤壁市人民医院急诊科收治的急性呼吸衰竭患者70例为观察对象,应用信封法随机分为对照组与观察组,各35例。在常规治疗基础上,观察组给予无创正压通气干预,对照组给予有创机械通气干预,比较两组患者血二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))、酸碱度(pH)、呼吸商(RQ)、每分钟通气量(VE)、临床疗效、不良反应发生率、死亡病例与平均住院时间。结果:治疗后,两组患者PaO2、pH、RQ、VE水平均提高,PaCO_(2)水平下降,差异有统计学意义(P<0.05),但治疗后观察组与对照组上述指标比较,差异无统计学意义(P>0.05);两组患者临床治疗总有效率比较,差异无统计学意义(P>0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05);两组急性呼吸衰竭患者住院期间未见死亡病例,观察组平均住院时间少于对照组,差异有统计学意义(P<0.05)。结论:无创正压通气应用于急诊救治急性呼吸衰竭患者中效果显著,明显改善血气分析及肺功能指标,安全性较优,可以明显缩短住院时间。

Objective:To explore the application value of non-invasive positive pressure ventilation in emergency treatment of acute respiratory failure.Methods:A total of 70 patients with acute respiratory failure treated in the Emergency Department of Chibi People's Hospital from January 2017 to June 2020 were selected as the observation subjects,and they were divided into control group and observation group according to random envelope method,with 35 cases in each group.On the basis of routine treatment,the observation group was given non-invasive positive pressure ventilation,and the control group was given invasive mechanical ventilation.The partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),acidity(pH),respiratory quotient(RQ),ventilation per minute(VE),clinical efficacy,incidence of adverse reactions,death cases and mean length of hospital stay were compared between the two groups.Results:After treatment,the PaO_(2),pH,RQ and VE levels increased while PaCO_(2) levels decreased in both groups,and the differences were statistically significant(P<0.05),but the differences were not statistically significant in the above indexes between the observation group and the control group after treatment(P>0.05);there were no statistically significant differences in total effective rate of clinical treatment between two groups(P>0.05);the incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05);no death was seen during the hospitalization of patients with acute respiratory failure in the two groups,and the mean length of hospital stay in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Non-invasive positive pressure ventilation is significantly effective in emergency treatment of patients with acute respiratory failure.It can significantly improve blood gas analysis and pulmonary function indexes,have a better safety,and significantly shorten the length of hospital stay.