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目的探讨急诊中无创正压通气(NPPV)对重症急性胰腺炎(SAP)合并肺损伤[急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)]患者的治疗作用,为无创正压通气用于SAP合并肺损伤的急诊救治提供依据。方法选择2013年1月-2015年3月在绵阳市中心医院急诊危重症监护室治疗的SAP合并ALI/ARDS患者56例,将进行NPPV的28例患者作为治疗组,未进行NPPV的患者28例作为对照组,观察两组治疗前及治疗3 d后血气分析,比较两组患者的住院时间及病死率。结果两组治疗前p H值和动脉血氧分压(Pa O2)差异无统计学意义(P>0.05),治疗3 d后治疗组、对照组p H值分别为7.41±0.07、7.34±0.04,Pa O2分别为(60.60±5.11)、(48.40±3.57)mm Hg(1 mm Hg=0.133 k Pa),差异均有统计学意义(P<0.05)。治疗组、对照组住院时间分别为(18.22±3.07)、(23.47±3.55)d,差异有统计学意义(P<0.05);治疗组、对照组6个月病死率分别为17%、32%,差异无统计学意义(P>0.05)。结论急诊中NPPV可以通过改善SAP合并ALI/ARDS患者的氧合状态,减轻低氧损害有效缩短患者住院时间。
Objective To investigate the therapeutic effect of noninvasive positive pressure ventilation (NPPV) in patients with severe acute pancreatitis (SAP) combined with lung injury [acute lung injury (ALI) / acute respiratory distress syndrome (ARDS)] in emergency. Provide a basis for the emergency treatment of SAP complicated with lung injury. METHODS: From January 2013 to March 2015, 56 patients with SAP-combined ALI / ARDS in emergency critical care unit in Mianyang Central Hospital were enrolled. Twenty-eight patients with NPPV were enrolled as treatment group, and 28 patients without NPPV As a control group, blood gas analysis was performed before treatment and after 3 days of treatment, and the hospitalization time and mortality of the two groups were compared. Results There was no significant difference in p H value and Pa O2 between two groups before treatment (P> 0.05). After 3 days of treatment, the values of p H in treatment group and control group were 7.41 ± 0.07 and 7.34 ± 0.04 PaO2 were (60.60 ± 5.11) and (48.40 ± 3.57) mm Hg respectively (1 mm Hg = 0.133 kPa), the difference was statistically significant (P <0.05). The hospitalization time of the treatment group and the control group were (18.22 ± 3.07) and (23.47 ± 3.55) days respectively, with significant difference (P <0.05). The 6-month mortality rates of the treatment group and the control group were 17% and 32% , The difference was not statistically significant (P> 0.05). Conclusion NPPV can shorten the length of hospital stay effectively by improving the oxygenation status of SAP patients with ALI / ARDS and reducing the hypoxic damage.