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目的 :探讨无创正压通气 (NPPV)在救治急性呼吸衰竭 (ARF)中的应用价值。方法 :6 2例各种原因引起的ARF患者随机分为两组 :标准治疗组 (ST组 ) :只给予针对病因的标准治疗 ;NPPV组 :在进行标准治疗同时加用NPPV。面罩连接呼吸机 ,通气模式采用压力支持通气 (PSV)加呼气末正压 (PEEP)。治疗前与治疗后 1h、6h及第 2天后每日测定动脉血气分析 ,并监测生命体征。结果 :NPPV组治疗后 1～ 6h ,PaO2 ,PaCO2 和PH较治疗前明显改善 (P <0 .0 5 ) ,心率和呼吸减慢 (P <0 .0 5 )。ST组治疗前后的动脉血气和心率呼吸均无显著变化 (P >0 .0 5 )。NPPV组治疗的失败率低于ST组 (P <0 .0 5 ) ,平均住院天数短于ST组 (P <0 .0 5 )。结论 :NPPV能迅速改善ARF患者的气体交换和生命体征 ,提高救治成功率 ,缩短住院时间。在ARF救治过程中NPPV可作为经过选择的患者首选的通气支持治疗手段。
Objective: To investigate the value of noninvasive positive pressure ventilation (NPPV) in the treatment of acute respiratory failure (ARF). Methods: Sixty-two patients with various causes of ARF were randomly divided into two groups: standard treatment group (ST group): only standard treatment for etiology; NPPV group: NPPV plus standard treatment. The mask is connected to the ventilator and the ventilation mode is pressure-assisted ventilation (PSV) plus positive end expiratory pressure (PEEP). Arterial blood gas analysis was performed daily before treatment and 1h, 6h and 2d after treatment, and vital signs were monitored. Results: PaO2, PaCO2 and PH of NPPV group were significantly improved (P <0.05), and heart rate and respiration decreased 1 ~ 6 h after treatment (P <0.05). There was no significant change in arterial blood gas and heart rate before and after treatment in ST group (P> 0.05). The failure rate of NPPV group was lower than that of ST group (P <0.05), and the average length of stay was shorter than that of ST group (P <0.05). Conclusion: NPPV can rapidly improve the gas exchange and vital signs of patients with ARF, improve the success rate of treatment and shorten the hospital stay. NPPV can be the preferred ventilation support treatment for selected patients during ARF treatment.