摘要
目的：对开放式高频喷射通气（ＨＦＪＯＶ）用于重症烧伤患者长期呼吸支持的效果、并发症和预后进行评价。方法：分析９７例重症烧伤患者持续应用ＨＦＪＯＶ辅助通气当日、第２天、第６天或第１０天以上的疗效，根据显效、有效和无效３种标准予以判定。结果：ＨＦＪＯＶ使用当日总有效率６５．０％，第２天后疗效进行性降低，至第１０天后仅３１．８％（Ｐ＜０．０１）。呼吸道损伤出血是最常见和最严重的并发症，ＨＦＪＯＶ使用６天后，发生率从５６．７％升至８１．８％（Ｐ＜０．００１）；而后为呼吸性碱中毒、血或痰块引起的气道阻塞和呼吸性酸中毒。呼吸功能衰竭仍然是主要死因。结论：由于气道开放，ＨＦＪＯＶ技术难以实施湿化、温化、灭菌、氧浓度监测和调节；因此，长时间使用ＨＦＪＯＶ可能使通气效率降低，引起气道损伤；ＨＦＪＯＶ无效或须应用４天以上时，应更换其它通气支持方式；对严重肺损伤患者，ＨＦＪＯＶ不宜作为首选的呼吸支持方式。
Objective:To determine the therapeutic effectiveness,complication and outcome of high frequency jet open ventilation (HFJOV) in treatment of respiratory dysfunction following severe burn injury.Methods:Nintyseven severe burn patients received HFJOV treatment,and their therapeutic effects at different days received HFJOV were analyzed.Results:The effective rate was 65 0% following HFJOV,and then gradually reduced to 31 8% after 10 HFJOV days ( P <0 01).Incidence of respiratory tract bleeding which was the most common and severe complication increased from 56 7% after 6 HFJOV days to 81 8% after 10 HFJOV days ( P <0 001).Respiratory alkalosis and airway obstruction as well as acidosis were common complications also.Respiratory failure remained major cause of death.Conclusions:The dry and cold jet airflow,due to airway opened and lack of humidifier,thermostat,and oxygen content regulator in HFJOV circuit,may insult respiratory tract.Therefore,long term treatment of HFJOV for ventilation support is not suitable for severe lung injury.
出处
《中国危重病急救医学》
CAS
CSCD
1997年第10期609-611,共3页
Chinese Critical Care Medicine
关键词
烧伤
呼吸衰竭
机械通气
高频喷射
burn
respiratory failure
high frequency jet open ventilation
