摘要
目的探讨双水平无创正压通气(BiPAP)对心脏外科术后需要二次机械辅助通气患者的治疗效果。方法 2008年9月-2009年9月,收集心脏外科手术后成功脱离呼吸机辅助通气后心功能衰竭或呼吸功能衰竭需要二次机械通气的患者,符合纳入及排除标准者共53例,进行回顾性分析,根据治疗方案分为无创通气组(32例)和有创通气组(21例),在需要机械通气时(T1),机械通气后30min(T2),机械通气后2h(T3)及预计脱离机械通气时(T4),分别统计患者心率、血气分析等情况,比较氧分压、ICU停留时间及术后至出院时间。结果给予辅助通气前,两组患者的心率及PO2无统计学差异(P>0.05)。给予辅助通气后,无创通气组患者的心率由T1(130.8±21.10)次/min,下降到T2(125.60±21.36)次/min,T3(101.70±13.73)次/min,T4(87.40±9.35)次/min;PO2由T1(64.70±14.12)mmHg,上升到T2(121.40±30.19)mmHg,T3(140.40±25.29)mmHg,T4(132.90±16.33)mmHg。有创通气组患者的心率由T1(138.27±21.39)次/min,下降到T2(118.18±18.03)次/min,T3(100.00±11.73)次/min,T4(87.00±10.70)次/min;PO2由T1(61.45±13.56)mmHg上升到T2(122.55±29.50)mmHg,T3(138.91±24.77)mmHg,T4(133.55±18.00)mmHg。两组患者心率及PO2均较辅助通气前降低(P<0.05)。两组患者之间各时间点心率及PO2比较无差异(P>0.05)。无创通气组的ICU停留时间及术后至出院时间分别为(1.75±2.97)d及(9.14±4.11)d,均低于有创通气组的(4.38±5.13)d及(14.00±0.82)d,有统计学意义(P<0.05)。结论双水平无创正压通气可用于心脏外科术后需要二次机械通气的患者。
Objective To investigate the effectiveness of bi level positive airway pressure （BiPAP） mechanical ventilation on heart surgery patients who require secondary mechanical ventilation. Methods There were 53 cases of patients who needed secondary ventilation from September 2008 to September 2009. According to the therapy method, they was divided into two groups （non-invasive ventilation group and the invasive ventilation group）. In the four time point Eat the time of need for mechanical ventilation （T1）, after 30 minutes of mechanical ventilation （T2）, after 2 hours of mechanical ventilation （T3） and before the patients were presumed to depart from mechanical ventilation （T4）], the data of the patients, such as heart rates, blood gas analysis, oxygen partial pressure, ICU staying time and postoperative time, were recorded and compared. Results Before and after ventilation, their heart rates decreased （P^0.05）, oxygen partial pressure improved （P^0. 05）; but there were no significant difference between the two groups （P〉0. 05） ; And the ICU stay and postoperative time of non-invasive ventilation group were significantly lower than the invasive ventilation group （P〈0. 05）. Conclusion Bi-level positive airway pressure mechanical ventilation can be used for cardiac surgery patients who require secondary mechanical ventilation.
出处
《华西医学》
CAS
2010年第3期533-535,共3页
West China Medical Journal
关键词
机械通气
心脏外科
ICU
Mechanical ventilation
Cardiac surgery
ICU
