摘要
目的评价无创机械通气治疗高龄不宜气管插管患者多器官功能衰竭的效果。方法 18例高龄不宜气管插管的多器官功能衰竭患者给予常规治疗,包括抗感染、抗炎、支气管扩张剂以及相应的对症治疗,同时采取BiPAP呼吸机行无创机械通气,在机械通气前、机械通气后2 h、12 h做血气分析,并观察临床效果。结果 13例患者被成功救治,5例患者死亡,病死率为27.8%,成功救治者和失败者之间在器官衰竭数、APACHEⅡ评分、治疗2 h及12 h后pH、PaCO2、治疗后12 h PaO2有明显差异(P<0.01)。结论无创机械通气可用于高龄不宜气管插管患者多器官功能衰竭的治疗,器官衰竭数、APACHEⅡ评分及治疗后早期血气改善情况等因素可影响NIMV的救治成功率。
Objective To evaluate the effectiveness of noninvasive mechanical ventilation（NIMV） in elderly patients with multi- ple organ failure, who were unsuitable to trachea cannula due to advanced age or critical conditions. Methods 18 elderly patients with multiple organ failure, and with unsuitable to trachea cannula, were under treatment with noninvasive mechanical ventilation based on con- ventional antibiotics, such as antibiotics, systemic corticosteroids, bronchodilators and appropriate medical therapy. Clinical indexes and arterial blood gas parameters were observed before and after 2 h, 12 h of continuous ventilation. Results 13 patients were successfully treated with NIMV while 5 patients were dead. The mortality rate was 27.8%. There were significant differences （P 〈0. 01 ） in the num- ber of organs in failure, APACHE scores, pH, PaCO2 after 2 h, 12 h and PaO2 after 12 h between patients successfully and unsuccessfully were treated. Conclusions Elderly patients with multiple organ failure, and with unsuitable to trachea cannula can be successfully treated by NIMV. APACHE scores, pH, PaCO2 after 2 h, 12 h and PaO2 after 12 h are the factors in influencing the outcome of NIMV.
出处
《临床肺科杂志》
2012年第8期1410-1411,共2页
Journal of Clinical Pulmonary Medicine
关键词
无创机械通气
多器官功能衰竭
高龄
Noninvasive mechanical ventilation
multiple organ failure
elderly patients
