无创通气救治间质性肺疾病合并呼吸衰竭的临床研究.pdfVIP

· 毫题研夯 · J Med Res，June 2008，Vo1．37 No．6 无创通气救治间质性肺疾病合并呼吸衰竭的临床研究 赵 红 王春兰 迟 磊 李丽娜 苗淑贤 摘 要 目的 探讨无创机械通气治疗间质性肺疾病合并呼吸衰竭的临床效果及可行性。方法 选择2004年2月～2007 年10月间我院收治的37例间质性肺疾病合并呼吸衰竭病人，随机分为治疗组和对照组，治疗组在对照组常规药物治疗基础上 经面罩行无创通气，观察两组患者的症状、体征、血气改变及最后转归。结果 与对照组相比，治疗组患者病情和血气分析指标 恢复较快。结论 无创通气治疗间质性肺疾病合并呼吸衰竭是安全有效和可行的，可减少并发症，挽救病人生命。 关键词 无创通气 间质性肺疾病 呼吸衰竭 CIi cal Evaluation of NIPPV in the Treatment of Interstitial Lung Disease Combined with Respiratory Failure Zhao Hong．Wang Chun· lan，Chi Lei，Li Lina，Miao Shuxian．People’S Hospital of Daqing，Heilongfiang 163316，China Abstract Objecfive To discuss the effect and possibility of NIPPV in ILD combined with respiratory failure．Methods A total of 37 crises of ILD combined with respiratory failure admitted by our hospital during Feb 2004 to Oct 2007 were divided into treatment group (20 cases)and control group(17 cases)．Routine pharmaceutical intervention was adopted in both groups while NIPPV was given in the patients of treatment group．The symptoms、signs and the arterial blood gases were observed and analyzed．Results Among 20 patients， 3 gave up treatment，17 patients were successfully treated with the NIPPV therapy．There were significant improvement of PaCO2、PaO2、 pH and respiratory rate，heart rate after 2h NIPPV．Conclusion NIPPV is an effective method for IL1)combined with respiratory failure， which can save the patients life and decrease the complications． Key words NIPPV；ILD；Respiratory failure 无创机械通气(NIPPV)因疗效肯定，并发症少，使用简 公司生产的BiPAP S／T D30型呼吸机，采用s—T模式，初始 单，费用低，易被患者接受而越来越广泛地应用于临床，其优 吸气压力(IPAP)6～8cmH O，呼气压力(EPAP)0～2cmH O。 点在于可避免气管切开或插管，更符合生理状态而达到机械 在病人耐受后逐渐调整吸气压力至 l2～18cmH：0，呼气压力 通气的目的。近年来，临床应用 NIPPV治疗 COPD急性加重 至4～6 cmH 0，控制吸入氧流量使血氧饱和度略高于90％。 (AECOPD)并呼吸衰竭取得了显著进展” ，但对间质性肺疾 病情稳定后逐渐下调参数，缩短上机时间直至完全撤机。观 病合并呼吸衰竭病人尚未有报道。我科采用无创通气治疗间