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目的观察无创正压通气(NPPV)及有创正压通气(IPPV)治疗光气中毒致急性呼吸窘迫综合征(ARDS)的临床疗效。方法对皖北煤电集团总医院重症监护病房收治的9例光气中毒致ARDS患者,随机分别采用NPPV及IPPV治疗,比较两组患者的呼吸机使用时间、住院时间、镇静剂使用及并发症发生情况。结果 9例患者均康复出院。NPPV治疗组5例患者中,平均使用呼吸机时间76.5 h,平均住院时间13.8 d,均未使用镇静剂,均未发生机械通气相关并发症。IPPV治疗组4例患者中,平均使用呼吸机时间82.5 h,平均住院时间22.2 d,均需要使用镇静剂,有2例患者出现机械通气相关并发症。NPPV治疗组患者的住院时间及并发症明显短或少于IPPV治疗组。结论对光气中毒致ARDS早期患者,选择NPPV与IPPV治疗,都是有效可行的;两者相比,NPPV具有无创性,不需要使用镇静剂,能缩短住院时间,减少并发症的发生,疗效优于IPPV。
Objective To observe the clinical effects of noninvasive positive pressure ventilation (NPPV) and invasive positive pressure ventilation (IPPV) in the treatment of acute respiratory distress syndrome (ARDS) caused by phosgene poisoning. Methods Nine patients with ARDS induced by phosgene in the ICU general hospital ward of Wanbei Coal Group were randomly divided into two groups. Happening. Results All 9 patients were recovered and discharged. Among 5 patients in NPPV treatment group, the average duration of respirator was 76.5 h and the average length of stay was 13.8 d. No sedation was used, and no complications related to mechanical ventilation occurred. Among the 4 IPPV-treated patients, the mean duration of ventilator use was 82.5 h and the average length of hospital stay was 22.2 d, both of which required sedation and 2 of whom experienced mechanical ventilation-related complications. The length of hospital stay and complications in NPPV-treated patients were significantly shorter or less than those in IPPV-treated patients. Conclusions NPPV and IPPV are both effective and effective in the early stage of ARDS induced by phosgene poisoning. Compared with NPPV, NPPV is noninvasive and does not require sedation, which can shorten the hospital stay and reduce the incidence of complications. At IPPV.