无创机械通气在卒中相关性肺炎患者中的临床应用

Clinical application of noninvasive mechanical ventilation in patients with stroke associated pneumonia

目的探讨无创机械通气在卒中相关肺炎(SAP)患者中的临床应用。方法回顾性分析2017年1月至2020年12月本院收治的89例SAP患者的临床资料,根据有无使用无创机械通气分为观察组(n=43)和对照组(n=46)。观察组给予无创机械通气治疗,对照组给予常规吸氧治疗。比较两组临床疗效、治疗前后血气分析指标[血氧饱和度(SaO_(2))、氧分压(PO_(2))、二氧化碳分压(PCO_(2))、乳酸(Lac)]及炎症因子指标[C-反应蛋白(CRP),白细胞介素-6(IL-6)、降钙素原(PCT)]。结果观察组治疗总有效率为88.37%,高于对照组的71.73%,差异有统计学意义(P<0.05)。治疗后,两组SaO_(2)、PO2水平高于治疗前,PCO_(2)、Lac水平低于治疗前,且观察组SaO_(2)、PO_(2)水平高于对照组,PCO_(2)、Lac水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CRP、IL-6、PCT水平均低于治疗前,且观察组CRP、PCT均低于对照组,差异有统计学意义(P<0.05),两组IL-6水平比较差异无统计学意义。结论无创机械通气治疗SAP疗效显著,其操作简单,安全性高,患者及家属接受度高,可明显降低气管插管率,有效缓解病情,缩短住院时间,减少费用,值得临床推广应用。

Objective To explore the clinical application of noninvasive mechanical ventilation in patients with stroke associated pneumonia(SAP).Methods The clinical data of 89 patients with SAP admitted to our hospital from January 2017 to December 2020 were retrospectively analyzed,and they were divided into observation group(n=43)and control group(n=46)according to the use of noninvasive mechanical ventilation.The observation group was given noninvasive mechanical ventilation treatment,and the control group was given conventional oxygen therapy.The clini-cal efficacy,blood gas analysis indexes(oxygen saturation[SaO_(2)],partial pressure of oxygen[PO_(2)],partial pressure of carbon dioxide[PCO_(2)],lactic acid[Lac])and inflammatory factors(C-reactive protein[CRP],interleukin-6[IL-6],procalcitonin[PCT])before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 88.37%,which was higher than 71.73%in the control grou,and the difference was statistically significant(P<0.05).After treatment,the levels of SaO_(2)and PO_(2)of the two groups were higher than before,the levels of PCO_(2)and Lac were lower than before,and the levels of SaO_(2)and PO2 in the observation group were higher than control group,and the levels of PCO_(2)and Lac were lower than control group,the differences were statistically significant(P<0.05).After treatment,the levels of CRP,IL-6 and PCT in the two groups were lower than before treatment,and the CRP and PCT of the observation group were lower than those in the control group,the differences were statistically significant(P<0.05),but there was no statistically significant difference in the levels of IL-6 between the two groups.Conclusion Noninvasive mechanical ventilation ventilation is effective in the treatment of SAP,with simple operation,high safety,high acceptance by patients and their families,reducing the rate of tracheal intubation,effectively alleviating the disease,shortening the hospitalization course and cost,and is worthy of clinical application.