摘要
目的 回顾性分析外科重症监护室(SICU)无创正压通气(NIPV)治疗病例,探讨其在SICU中的临床应用价值。方法 收集SICU2001年6月～2002年5月NIPV治疗病例,记录病人治疗前一般情况、原发病、手术、APACHE Ⅱ评分、肺功能、动脉血气及NIPV治疗过程等,统计分析相关数据。结果 54例病人使用NIPV,抢救组47例,预防组7例。抢救组:APACHE Ⅱ评分平均值为(11.64±4.73)分。治疗前平均呼吸频率为(29.44±4.84)次/min,1h后为(25.15±4.93)次/mim(P<0.05);治疗前平均氧合指数为(154.06±77.03)mm Hg,1h后为(189.13±91.52)mm Hg(P<0.05)。未建立人工气道率为61.7％,NIPV治疗成功率为55.3％,生存率为76.6％。Binary Logistic分析,APACHE-Ⅱ评分和气道分泌物的多少对NIPV治疗效果的影响有统计学意义(P<0.05)。预防组:累计平均治疗时间为(41.43±6.97)h。术后未建立人工气道率、NIPV治疗成功率及生存率均为100％。未发生NIPV治疗相关性并发症。结论 NIPV在治疗手术后并发的急性呼吸衰竭和预防严重肺功能障碍病人术后肺部并发症的发生有肯定的价值;选择NIPV治疗的病例时应考虑病人的APACHE Ⅱ评分情况和气道分泌物多少;NIPV是一项安全和依从性好的治疗措施。
Objective To retrospectively analysis cases therapied by NIPV in SICU for evaluating application of NIPV in SICU.Methods All cases treated by NIPV in SICU were collected from Jun 2001 to May 2002.Data included general conditions,primary diseases,operations, APACHE score,lung function,blood gas and procedure of NIPV, etc.Results Total cases were 54, including 47 in group of rescue, and 7 in group of prophylaxis.Group of rescue: Mean scores of APACHE Ⅱ were 11.64 ± 4.73.Mean respiratory rate before therapy were (29.44±4.84)bpm,which were (25.15 + 4.93)bpm 1 hour after therapy( P < 0.05 ). Mean oxygenation index before therapy was (154.06 ± 77.03) mm Hg, which were (189.13191.52) mm Hg 1 hour after therapy(P<0.05) .Ratio of non-placing artificial trachea was 61.7%, successful ratio was 55.3 % , survival ratio was 76.6 % . In analysis of Binary logistic, impact of APACHE Ⅱ score and secretions of trachea on effect of NIPV was significant (P<0.05). Group of prophylaxis: Mean cumulative therapeutical time were (41.43 ± 6.97 ) hours.Ratio of non-placing artificial trachea was 100% ,successful ratio was 100% ,survival ratio was 100% .There were no complications associated with NIPV.Conclusions It is valuable that NIPV treats postoperative ARE and prevents postoperative pulmonary complications in patients of severe pulmonary dysfunction. APACHE Ⅱ score and secretions of trachea are important considerations in selecting suitable patients received NIPV. In generally NIPV is a safe and well-compliant treatment.
出处
《中国呼吸与危重监护杂志》
CAS
2002年第4期229-232,共4页
Chinese Journal of Respiratory and Critical Care Medicine
