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目的探讨无创呼吸机在呼吸衰竭经鼻气管插管序贯治疗中的可行性。方法 25例因呼吸衰竭行经鼻气管插管有创通气的患者,病情稳定,肺部感染基本控制,且均有自主呼吸,有创呼吸机的通气模式为压力支持,但脱机困难,改用无创呼吸机连接气管插管导管行有创通气序贯呼吸支持治疗,并选择合适的时机拔管,改面罩行无创通气。观察患者的血气分析变化及预后情况。结果应用无创呼吸机前后酸碱度(p H)、动脉血氧分压(Pa O2)、动脉二氧化碳分压(Pa CO2)、血氧饱和度(Sa O2)比较差异无统计学意义(P>0.05),25例患者中21例成功拔除气管插管导管并停用无创呼吸机,1例行无创通气24周病情平稳,3例因再次感染死亡。结论无创呼吸机可应用于病情稳定但脱机困难的呼吸衰竭经鼻气管插管患者的序贯治疗中。
Objective To investigate the feasibility of noninvasive ventilator in sequential treatment of respiratory failure by nasotracheal intubation. Methods Twenty-five patients with invasive ventilation through nasotracheal intubation due to respiratory failure were in stable condition and with basic pulmonary infection control. Both of them had spontaneous breathing. Ventilation mode of invasive ventilator was pressure support, Noninvasive ventilator connected tracheal intubation catheter invasive ventilation sequential respiratory support therapy, and choose the right time to extubation, change the mask noninvasive ventilation. Observe the patient’s blood gas analysis and prognosis. Results There was no significant difference in p H, Pa O2, Pa CO2 and Sa O2 before and after non-invasive ventilator (P> 0.05) Among the 25 patients, 21 patients successfully removed the endotracheal intubation catheter and discontinued the noninvasive ventilator. One patient underwent noninvasive ventilation was stable at 24 weeks and 3 died of another infection. Conclusion Noninvasive ventilator can be used in the sequential treatment of patients with respiratory failure and nasal endotracheal intubation who are in stable condition but have difficulty in taking off-line.