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目的观察并探讨早期机械通气救治急性中毒导致呼吸衰竭临床疗效及安全性。方法回顾性分析某院2006年3月～2010年5月急诊科收治急性中毒导致呼吸衰竭患者47例临床抢救资料,其中24例患者在呼吸停止后5min内行气管插管机械通气,设为对照组;23例患者在自主呼吸存在条件下,依据昏迷、发绀等临床症状以及呼吸监测指标,早期给予气管插管机械通气,设为实验组;评价临床痊愈率,呼吸机使用时间及并发症发生情况。结果对照组与实验组患者临床痊愈率分别为70.8%、100%;实验组患者临床痊愈率明显高于对照组,两组间比较差异有统计学意义(P﹤0.05);对照组及实验组患者呼吸机使用时间分别为(82.5±10.5)h、(53.1±7.6)h;实验组患者呼吸机使用时间明显少于对照组,两组间比较差异有统计学意义(P﹤0.05);同时对照组与实验组患者肺部感染发生率分别为为87.5%、60.7%;对照组与实验组患者低血压发生率分别为16.7%、4.3%;实验组患者肺部感染及低血压发生率均明显低于对照组,两组间比较差异有统计学意义(P﹤0.05)。结论早期机械通气救治急性中毒临床效果确切,可以有效提高抢救成功率,降低机械通气相关并发症发生率,具有临床推广使用价值。
Objective To observe and discuss the clinical efficacy and safety of early mechanical ventilation in the treatment of respiratory failure caused by acute poisoning. Methods A retrospective analysis of 47 cases of acute respiratory failure patients admitted to the emergency department from March 2006 to May 2010 in the emergency department was performed. Among them, 24 patients underwent mechanical ventilation during tracheal intubation within 5 minutes after respiration, ; 23 patients under the conditions of spontaneous breathing, based on coma, cyanosis and other clinical symptoms and respiratory monitoring indicators, early mechanical ventilation tracheal intubation, as the experimental group; evaluation of clinical cure rate, ventilator use time and complications . Results The clinical cure rates of the control group and the experimental group were 70.8% and 100% respectively. The clinical cure rate of the experimental group was significantly higher than that of the control group, with significant difference between the two groups (P <0.05) The duration of use of ventilator in patients was (82.5 ± 10.5) h and (53.1 ± 7.6) h, respectively. The use of ventilator in the experimental group was significantly less than that in the control group, with significant difference between the two groups (P <0.05) The incidence of pulmonary infection in the control group and the experimental group was 87.5% and 60.7% respectively; the incidences of hypotension in the control group and the experimental group were 16.7% and 4.3% respectively; both the pulmonary infection and the incidence of hypotension in the experimental group were Significantly lower than the control group, the difference between the two groups was statistically significant (P <0.05). Conclusions Early mechanical ventilation is effective in treating acute poisoning, which can effectively improve the success rate of rescue and reduce the incidence of complications related to mechanical ventilation. It has the value of clinical popularization and use.