双水平正压无创通气治疗肺结核并发呼吸衰竭临床观察
|
摘要
目的:观察双水平正压(BiPAP)无创通气治疗肺结核并发呼吸衰竭的疗效。方法:选择我院2010-2012年的48例肺结核并发呼吸衰竭的住院患者,随机分为治疗组24例,采用BiPAP呼吸机经面罩无创通气治疗;对照组24例,采用鼻导管吸氧。两组均常规给予抗结核,抗感染,解痉,祛痰,纠正酸碱失衡,电解质紊乱治疗,对治疗前后血气分析的PH值,氧分压(PaO2),二氧化碳分压(PaCO2),氧饱和度(SaO2),心率,呼吸频率,血压进行观察。结果:BiPAP无创通气治疗24h后PaO2,SaO2均明显升高,PaCO2明显降低,心率,呼吸频率指标均有明显改善,治疗前后比较差异有统计学意义(P<0.01),但血压治疗前后无明显变化。结论:BiPAP无创通气治疗肺结核合并呼吸衰竭疗效肯定,并发症少,值得临床推广。
Objective:To observe the clinical effect of two-level non-invasive positive pressure ventilation in the treatment of tuberculosis and respiratory failureMethod:Forty eight cases of tuberculosis patients with respiratory failure admitted in our hospital in 2010-2012years were selected in the study.The patients were randomly divided into treatment group and control group.Patients in treatment group(24cases) were treated with noninvasive ventilation BiPAP ventilator through the mask.Patients in the control group(24cases) were administered oxygen inhalation through nasal catheter.Regular anti-tuberculosis,anti-infection,spasmolysis,expectorant,correcting acid-base imbalance,electrolyte disorder treatment were applied in both group.Blood gas analysis before and after the treatment,oxygen partial pressure(PaO 2),co2partial pressure(PaCO 2),oxygen saturation(SaO 2),heart rate,breathing rate and blood pressure were observed.Result:After 24hours treatment with BiPAP non-invasive ventilation,PaO 2,SaO 2 significantly elevated,PaCO 2 decreased,heart rate,breathing rate index improved significantly compared before treatment with significant difference(P<0.01).There has no significant change in blood pressure before and after treatment.Conclusion:The curative effect of BiPAP noninvasive ventilation on tuberculosis combined with respiratory failure has fewer complications and worthy of clinical promotion.
Objective:To observe the clinical effect of two-level non-invasive positive pressure ventilation in the treatment of tuberculosis and respiratory failureMethod:Forty eight cases of tuberculosis patients with respiratory failure admitted in our hospital in 2010-2012years were selected in the study.The patients were randomly divided into treatment group and control group.Patients in treatment group(24cases) were treated with noninvasive ventilation BiPAP ventilator through the mask.Patients in the control group(24cases) were administered oxygen inhalation through nasal catheter.Regular anti-tuberculosis,anti-infection,spasmolysis,expectorant,correcting acid-base imbalance,electrolyte disorder treatment were applied in both group.Blood gas analysis before and after the treatment,oxygen partial pressure(PaO 2),co2partial pressure(PaCO 2),oxygen saturation(SaO 2),heart rate,breathing rate and blood pressure were observed.Result:After 24hours treatment with BiPAP non-invasive ventilation,PaO 2,SaO 2 significantly elevated,PaCO 2 decreased,heart rate,breathing rate index improved significantly compared before treatment with significant difference(P<0.01).There has no significant change in blood pressure before and after treatment.Conclusion:The curative effect of BiPAP noninvasive ventilation on tuberculosis combined with respiratory failure has fewer complications and worthy of clinical promotion.
引文
[1]万成福,白炳秀,万方.双水平无创呼吸机治疗AE-COPD和并Ⅱ型呼吸衰竭临床观察[J].实用临床医药杂志,2009,13(23):37-38.
[2]ESTES R J,MEDURI G U.The pathe genesis of Ven-tilatorassociated pneumonia.Ⅰmechanisms of bacterialtranscolonization and airway intensive Intersine care[J].MEP,1995,21:365-383.
[3]王辰,商鸣宇,黄克武,等.有创与无创序贯机械通气治疗慢性阻塞性肺疾病所致严重呼吸衰竭的研究[J].中华结核和呼吸杂志,2000,23(4):212-216.
[4]郑玉琼,马敏,田青,等.BiPAP呼吸机治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效观察[J].中国呼吸与危重监护杂志,2003,2:374-375.
[5]徐喜嫒,姚易凯,杨敬平.BiPAP呼吸机治疗慢性阻塞性肺疾病急性呼吸衰竭的疗效观察[J].中国呼吸与危重监护杂志,2003,2:360-361.
[6]王永,范远成,朱宝山.无创正压通气加平台呼气阀联合呼吸兴奋剂治疗COPD肺性脑病的临床研究[J].中国呼吸与危重监护杂志,2010,9(4):344-347.
[7]中华医学会结核分会.肺结核诊断与治疗指南[J].中华结核与呼吸杂志,2001,24(2):70-72.
[8]刘烨,支太禹,罗绍友.无创正压通气治疗Ⅱ型呼吸衰竭疗效观察[J].贵阳医学院学报,2007,32(3):392-393.
[9]刘又宁,丁杰.压力支持通气在呼吸衰竭中的作用.中华结核与呼吸杂志,1991,14(1):50-52.
[10]STANKOV Y,STOURAC P,SKRICKOV J.Care for patients on mechanical ventilation from the perspectice of an internal medicine physician[J].Vnitr Lek,2010,56:801-809.
[11]马屿,朱莉贞,潘毓萱.结核病[M].北京:人民卫生出版社,2006:401-402.
[12]NUNES P,ABADESSO C,ALMEIDA E,et al.Non invasive ventilation in a pediatric intensice care cunit[J].Act a Med port,2010,23:399-404.
[13]李春莲,唐国惠.双水平气道正压无创通气治疗老年性阻塞性肺疾病[J].贵阳医学院学报,2006,31(4):373-374.
[2]ESTES R J,MEDURI G U.The pathe genesis of Ven-tilatorassociated pneumonia.Ⅰmechanisms of bacterialtranscolonization and airway intensive Intersine care[J].MEP,1995,21:365-383.
[3]王辰,商鸣宇,黄克武,等.有创与无创序贯机械通气治疗慢性阻塞性肺疾病所致严重呼吸衰竭的研究[J].中华结核和呼吸杂志,2000,23(4):212-216.
[4]郑玉琼,马敏,田青,等.BiPAP呼吸机治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效观察[J].中国呼吸与危重监护杂志,2003,2:374-375.
[5]徐喜嫒,姚易凯,杨敬平.BiPAP呼吸机治疗慢性阻塞性肺疾病急性呼吸衰竭的疗效观察[J].中国呼吸与危重监护杂志,2003,2:360-361.
[6]王永,范远成,朱宝山.无创正压通气加平台呼气阀联合呼吸兴奋剂治疗COPD肺性脑病的临床研究[J].中国呼吸与危重监护杂志,2010,9(4):344-347.
[7]中华医学会结核分会.肺结核诊断与治疗指南[J].中华结核与呼吸杂志,2001,24(2):70-72.
[8]刘烨,支太禹,罗绍友.无创正压通气治疗Ⅱ型呼吸衰竭疗效观察[J].贵阳医学院学报,2007,32(3):392-393.
[9]刘又宁,丁杰.压力支持通气在呼吸衰竭中的作用.中华结核与呼吸杂志,1991,14(1):50-52.
[10]STANKOV Y,STOURAC P,SKRICKOV J.Care for patients on mechanical ventilation from the perspectice of an internal medicine physician[J].Vnitr Lek,2010,56:801-809.
[11]马屿,朱莉贞,潘毓萱.结核病[M].北京:人民卫生出版社,2006:401-402.
[12]NUNES P,ABADESSO C,ALMEIDA E,et al.Non invasive ventilation in a pediatric intensice care cunit[J].Act a Med port,2010,23:399-404.
[13]李春莲,唐国惠.双水平气道正压无创通气治疗老年性阻塞性肺疾病[J].贵阳医学院学报,2006,31(4):373-374.