摘要
目的 :探讨无创正压通气 (NIPPV)治疗急性呼吸窘迫综合征 (ARDS)改善疗效的因素。方法 :2 3例ARDS患者按诱发因素分为肺内因素组 (A组 )和肺外因素组 (B组 )。选择不同呼吸机和鼻 (面 )罩行 NIPPV ,采用双相压力支持通气 (Bi PAP) ;多功能呼吸机采用压力支持通气 (PSV) +呼气末正压 (PEEP)或同步间歇指令通气 (SIMV) +PSV +PEEP。通气 3～ 10 h,不适合 NIPPV的患者改建人工气道通气。结果 :全程进行 NIPPV治疗的患者 A组 5例 ,B组 12例 ;NIPPV治愈 A组为 5 5 .6 % (5 / 9) ;B组为 85 .7% (12 / 14 ) ,P<0 .0 5。结论 :选择合适的适应证 ,合理选择呼吸机、呼吸模式和治疗参数 ,并改善对 NIPPV不利的影响因素 ,可以减少人工气道的使用。
Objective: To investigate the factors affecting the effect of noninvasive positive pressure ventilation(NIPPV) on treatment of acute respiratory distress syndrome(ARDS). Methods: According to the diseaseinduced factors, patients with ARDS were divided into two groups: group A( pulmonary factors ), group B(extrapulmonary factors). Different kinds of ventilators were used in the course of NIPPV via facial or nasal mask. The mode, biphasic intermittent positive airway pressure(BiPAP, BiPAP vision), pressure surpport ventilation(PSV)+positive end expiratory pressure(PEEP) or synchronized intermittent mandatory ventilation(SIMV)+PSV+PEEP, was administered. After 310 hours, the patients who were not fit to NIPPV were conducted intubation. Results: Group A had 9 cases, of whom 5 cases were treated with NIPPV all the time, while in group B, 14 cases, of whom 12 cases The cure rate of group A by NIPPV was 55 6%(5/9), while that of group B was 85 7%(12/14), P <0 05. Conclusion: Selecting proper indication, reasonable ventilator mode and parameters, and improving the unfavorable factors can contribute to the decrease of intubation rate.
出处
《中国危重病急救医学》
CAS
CSCD
2003年第6期354-357,共4页
Chinese Critical Care Medicine
关键词
急性呼吸窘迫综合征
无创正压通气
面罩
acute respiratory distress syndrome
noninvasive positive pressure ventilation
facial mask
