机械通气治疗在重症急性肺水肿患者抢救过程中的应用价值分析
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摘要
目的探讨重症急性肺水肿患者抢救中应用机械通气治疗的效果。方法选择该院2013年3月—2018年5月接收的55例重症急性肺水肿患者为研究对象,所有患者均及时进行抢救,并且在抢救过程中给予所有患者进行机械通气治疗,分析机械通气前后患者临床指标、动脉血气情况及患者临床征象改善情况。结果机械通气后,患者呼吸频率、心率、收缩压及舒张压均较治疗前低,如通气后心率为(95.52±8.84)次/min,显著低于通气前(125.56±14.49)次/min(t=13.125,P<0.05);机械通气后,患者动脉血氧分压、动脉血氧饱和度、血清pH值均较通气前升高,动脉血二氧化碳分压较通气前下降,差异有统计学意义(P<0.05);术后随访53例(96.36%)患者病情好转,2例(3.64%)患者死亡。结论针对重症急性肺水肿患者,给患者行急诊抢救时配合机械通气治疗可以显著改善患者血气状况,提高患者抢救成功率,属于一种起效快及作用显著的方法。
Objective To study the effect of mechanical ventilation therapy in the rescue of patients with severe acute pulmonary edema. Methods 55 cases of patients with severe acute pulmonary edema treated in our hospital from March 2013 to May 2018 were selected and rescued, and all patients were for mechanical ventilation therapy, and the clinical indexes, artery blood gas and improvement of clinical signs of all patients were analyzed. Results After the mechanical ventilation, the respiration frequency, heart rate, systolic pressure and diastolic pressure of patients decreased compared with those before treatment, the heart rate after the ventilation was obviously lower than that before ventilation, [(95.52±8.84)times/min vs(125.56 ±14.49)times/min, t =13.125, P <0.05], after the mechanical ventilation, the arterial partial pressure of oxygen, arterial oxygen saturation and serum pH value increased compared with those before ventilation,and the partial pressure of carbon dioxide in artery decreased compared with those before ventilation, and the differences were statistically significant(P<0.05), and the disease of 53 cases 96.36% was improved shown by the postoperative follow-up, and 2 cases 3.64% died. Conclusion The emergency rescue and mechanical ventilation of patients with severe acute pulmonary edema can obviously improve the blood gas, and improve the emergency success rate, and it is a method with rapid onset and obvious effect.
Objective To study the effect of mechanical ventilation therapy in the rescue of patients with severe acute pulmonary edema. Methods 55 cases of patients with severe acute pulmonary edema treated in our hospital from March 2013 to May 2018 were selected and rescued, and all patients were for mechanical ventilation therapy, and the clinical indexes, artery blood gas and improvement of clinical signs of all patients were analyzed. Results After the mechanical ventilation, the respiration frequency, heart rate, systolic pressure and diastolic pressure of patients decreased compared with those before treatment, the heart rate after the ventilation was obviously lower than that before ventilation, [(95.52±8.84)times/min vs(125.56 ±14.49)times/min, t =13.125, P <0.05], after the mechanical ventilation, the arterial partial pressure of oxygen, arterial oxygen saturation and serum pH value increased compared with those before ventilation,and the partial pressure of carbon dioxide in artery decreased compared with those before ventilation, and the differences were statistically significant(P<0.05), and the disease of 53 cases 96.36% was improved shown by the postoperative follow-up, and 2 cases 3.64% died. Conclusion The emergency rescue and mechanical ventilation of patients with severe acute pulmonary edema can obviously improve the blood gas, and improve the emergency success rate, and it is a method with rapid onset and obvious effect.
引文
[1]丁毅.托拉塞米注射液联合机械通气+PEEP治疗重症急性肺水肿疗效分析[J].中国急救医学,2016,36(1):234-235.
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[6]Xiao-Lei MA,Neonatology DO,Hospital AC.Long and short-term effects of different mechanical ventilation in the treatment of severe neonatal respiratory distress syndrome[J].Clinical Research&Practice,2017.
[7]申强,吴铁军,王国青.机械通气治疗急性心肌梗死并急性肺水肿的临床效果观察[J].实用心脑肺血管病杂志,2016,22(8).
[8]陆启光.参附注射液联合有创机械通气治疗急性心源性肺水肿的临床效果分析[J].中华中医药学刊,2015,17(6):1533-1536.
[9]Uchiyama A.The Selection and Settings of Mechanical Ventilation Mode in Patients with Acute Respiratory Failure[J].Journal of Japan Society for Clinical Anesthesia,2015,35(1):089-097.
[10]季一娟,单红卫,巢益群,等.有创-无创序贯机械通气对急性心源性肺水肿患者低氧血症和血流动力学的影响[J].现代生物医学进展,2016,16(29):5651-5654.
[2]陆伟荣.有创机械通气在有机磷中毒合并难治性急性肺水肿患者中的临床疗效分析[J].中医学报,2014,14(B12):470-471.
[3]徐刚,董芳,董碧华,等.机械通气治疗急性心肌梗死合并急性肺水肿的临床效果[J].实用临床医药杂志,2016,20(3):7-10.
[4]Bao-Jia L I,Quan M O,Shi G J,et al.Study on the application value of percutaneous dilational tracheostomy on the rescue of patients with severe cerebrovascular accident[J].China Modern Medicine,2016.
[5]孟瑶.急性心肌梗死合并急性肺水肿应用机械通气辅助治疗的效果观察[J].中国煤炭工业医学杂志,2015,18(10):1639-1642.
[6]Xiao-Lei MA,Neonatology DO,Hospital AC.Long and short-term effects of different mechanical ventilation in the treatment of severe neonatal respiratory distress syndrome[J].Clinical Research&Practice,2017.
[7]申强,吴铁军,王国青.机械通气治疗急性心肌梗死并急性肺水肿的临床效果观察[J].实用心脑肺血管病杂志,2016,22(8).
[8]陆启光.参附注射液联合有创机械通气治疗急性心源性肺水肿的临床效果分析[J].中华中医药学刊,2015,17(6):1533-1536.
[9]Uchiyama A.The Selection and Settings of Mechanical Ventilation Mode in Patients with Acute Respiratory Failure[J].Journal of Japan Society for Clinical Anesthesia,2015,35(1):089-097.
[10]季一娟,单红卫,巢益群,等.有创-无创序贯机械通气对急性心源性肺水肿患者低氧血症和血流动力学的影响[J].现代生物医学进展,2016,16(29):5651-5654.