摘要
目的本文研究无创正压通气(NIPPV)对多种原因所致的急性呼吸衰竭的治疗效果。方法入选患者40例,包括慢性阻塞性肺疾病(COPD)急性加重期22例,急性左心功能衰竭4例,社区获得性肺炎(CAP)7例,其中4例并发急性呼吸窘迫综合症(ARDS)。支气管哮喘1例,肺癌术后2例,胸部外伤2例,胸腹复合伤2例。采用PSV(压力支持通气)+PEEP(呼气末正压)模式。结果COPD患者16例有效,有效率72·7%;外科患者5例有效,有效率83·3%;急性左心衰竭患者4例及支气管哮喘1例均有效,有效率100%。1例肺炎及1例肺炎合并ARDS患者有效,有效率28·6%。结论NIPPV对COPD急性加重期、急性左心功能衰竭、胸部外伤及手术后急性呼吸衰竭的治疗有一定的效果,在无禁忌症时可首选;对于肺炎所致的ARDS疗效较差,应首先考虑人工气道机械通气(ETMV)。
Objective To study the influence of NIPPV upon ARF resulting from several causes. Methods Forty patients were studied including 22 cases with acute exacerbations of chronic obstructive pulmonary disease （ AECOPD）, 4 left ventricular failure cases, 4 community acquired pneumonia （CAP） cases with ARDS, 2 cases after operation for lung cancer, 2 cases with chest injury and 2 cases with chest combined abdominal injuries. All of them were ventilated in the mode of pressure support ventilation （PSV） and positive end expiratory pressure （PEEP）. Results Sixteen COPD cases （ 72. 7% ） showed effectiveness, 5 cases with operation （ 83.3 % ） showed effectiveness, 4 cases with left ventricular failure （ 100% ） showed effectiveness and one case of pneumonia and with ARDS （ 25% ） showed effectiveness. Conclusion NIPPV had good effect in treating acute respiratory failure caused by AECOPD, acuter left ventricular failure, chest injury and/or operation. NIPPV should be preferred if there is no contraindictions. NIPPV doesnt have good effect on ARDS occuring with pneumonia. Endotracheal intubation mechanical ventilation （ETMV） should be the first choice for this kind of acute respiratory failure.
出处
《临床肺科杂志》
2007年第2期120-121,共2页
Journal of Clinical Pulmonary Medicine
关键词
无创正压通气
急性呼吸衰竭
noninvasive positive pressure ventilation
acute respiratory failure
