浅谈简易呼吸器的使用

简易呼吸器主要适用于窒息复苏,以达到人工通气的目的,它是危重病人的抢救、转运和呼吸机的过渡性急救器械。如急性呼吸衰竭时出现呼吸停止或呼吸微弱经积极治疗无改善,肺通气量明显不足;慢性重症呼吸衰竭,经各种治疗无改善或有肺性脑病者;呼吸机使用前或停用呼吸机时都需要用到简易呼吸器。简易呼吸器主要由压力释放阀、出     

医用简易呼吸装置的改进和临床应用

临床医用呼吸器装置是用于危重病人的紧急救护和辅助呼吸的设备.临床上一般配有儿童和成人两种简易呼吸器,在没有呼吸机而又需要辅助呼吸、或因为停电、呼吸机故障或现场临时救护等的情况下,简易呼吸器就成为给病人进行人工通气的唯一手段.     

简易呼吸器在早期心肺复苏中的应用(综述)

简易呼吸器是可借助人工器械加压的简易呼吸装置,具有使用方便、痛苦轻、并发症少、有无氧源均可立即通气的特点,在临床紧急救治中被广泛应用。在早期心肺复苏中应用简易呼吸器,能改善患者呼吸功能,有效地纠正低氧血症,为气管插管等进一步生命支持提供了较好的条件,为挽救生命赢得"宝贵时间",对提高早期心肺复苏的成功率有重要意义。     

基于ISO10651-4:2002《简易呼吸器专用要求》标准的简易呼吸器性能评价

简易呼吸器的临床性能对提高急救复苏的成功率至关重要。本文首先分析和解读了ISO10651-4:2002《简易呼吸器专用要求》标准,然后从输出氧浓度、死腔、呼气阻抗、吸气阻抗、最小通气容积和压力限制等方面比较了国内外市场上五种常见的成人用简易呼吸器的通气性能。     

简易呼吸器负压通气辅助治疗慢性阻塞性肺病的研究

目的：探索使用自制的简易呼吸器负压通气对慢性阻塞性肺病（COPD）的治疗作用。方法：68例COPD患者随机分为治疗组和对照组,其中治疗组35例,自制简易呼吸器连接吸引器调节负压可以使呼气相负压值为-5 cmH2O（1 cmH2O=98.063 8 Pa）,每天至少通气1 h,连续应用7 d;对照组33例,使用常规鼻导管吸氧。两组均按照常规给予抗感染及对症治疗。观察比较患者的肺功能、动脉血气、住院天数及费用。结果：与对照组相比,治疗组COPD患者的FVC、FEV1（%）、pa（O2）、pa（CO2）均有显著性改善（P〈0.01）。结论：简易呼吸器间歇负压通气对COPD患者有较为肯定的治疗作用。     

微型数显呼吸机在重危病人院内转运中的应用

目的:探讨HFS3100B微型数显呼吸机用于术后危重患者院内转运的应用价值。方法:对250例颅脑、心脏、复合伤手术后转运至重症监护病房(ICU)途中实施机械通气支持的危重患者进行随机分为2组:⑴微型数显呼吸机组、⑵通常使用的简易呼吸器组,记录通气效果。结果:使用微型数显呼吸机,患者血流动力参数和血气分析指标稳定,转送过程优于简易手控呼吸器。结论:新型HFS3100B微型数显呼吸机在危重患者的转运中可支持呼吸,操作便捷,安全可靠,值得大力推广使用。     

简易呼吸器在院前急救中的应用

我院2003年12月至2006年12月，“120”急救车接诊68例呼吸衰竭或呼吸停止的危重患者，采用简易呼吸器辅助呼吸，改善了患者的呼吸功能，大大提高了抢救的成功率，现报告如下。     

呼吸衰竭病人俯卧位通气的护理效果评价

目的探讨呼吸衰竭病人俯卧位通气的护理方法及效果。方法总结2011年8月—2012年8月该院收治的呼吸衰竭患者40例应用俯卧位通气的护理经验。结果患者经配合俯卧位通气辅助治疗3～7d后,均顺利脱机。初始通气与通气4、8、24h后的pH、PaCO2、PaO2、PaO2/FiO2值相比差异具有统计学意义（P〈0.05）。结论对呼吸衰竭来说,俯卧位通气是一种积极有效的辅助治疗措施,严格的监测以及护理能防止并发症的出现,同时还有利于俯卧位通气功能的发挥。     

呼吸器治疗新生儿呼吸衰竭22例的临床体会

目的探讨呼吸器治疗新生儿呼吸衰竭的临床效果。方法选取在该院新生儿科的22例呼吸衰竭的新生儿作为研究对象,使用呼吸器对这些患儿进行治疗。结果 22例患儿有15例得到治愈（68.2%）,自动出院的有4例（18.2%）,死亡的有3例（13.6%）;使用呼吸机后合并呼吸道感染的情况是：使用呼吸器4d以上者有9例,7例患者出现感染（77.8%）,h使用呼吸器1~4d者有11例,2例患者出现感染（18.2%）,使用呼吸器〈24h的患者有3例,没有出现感染的状况。使用呼吸机后,有1例合并纵膈积气,无合并气胸者。对患者进行痰培养为肺炎绿脓杆菌或者是克雷伯氏菌。结论呼吸器在治疗新生儿呼吸衰竭方面,可以保证患儿的氧合,改善通气状况,提高患儿的生存率。     

BiPAP压力支持通气在肺心病呼吸衰竭治疗中的应用

本文报告一种新的通气模式：使用ＢｉＰＡＰ压力支持通气治疗２０例肺心病合并Ⅱ型呼吸衰竭病人．并以同期同样标准的１０例病人作为对照．治疗前后均做血气分析，结果显示ＢｉＰＡＰ压力支持通气有明显改善通气提高ＰａＯ２、降低ＰａＣＯ２效果，鉴于它的无创性，有利于临床推广应用。本文并对压力支持通气的原理、指征、优缺点、注意事项等进行了讨论。     

Respiratory Fit Testing for Farmworkers in the Black Dirt Region of Hudson Valley,New York

Respiratory protection in agriculture has lagged behind other industries. Migrant farmworkers often work in dusty environments yet do not receive appropriate, fitted respiratory protection. During May and June of 2013, researchers pilot-tested a respiratory protection program adapted to fit the unique needs of migrant and seasonal farmworkers. It was implemented in Spanish, with literacy support, at convenient times and locations. Additionally, staff was known to workers, and a farmworker medical center provided medical follow-up. Fifty-six farmworkers participated (68%; 82 invited). Of the participants, 88% were male; 20% reported using respiratory protection. One worker had been fit tested previously; 57% reported being exposed to pesticides. All but six farmworkers passed the medical clearance (91%). The mask most commonly fit to the American-born population was a good fit for only 41% of Latino farmworkers. The fact that two thirds of invited farmworkers participated in the clearance and over half completed mask fitting indicates that the modified protocol meets farmworker needs. A wide range of mask types should be made available for Latino farmworkers.     

Determinants of pattern of breathing during respirator use

The relationship between the pattern of breathing in response to respirator-type loads and an individual's psychophysiologic sensitivity to loads (load scaling sensitivity, LSS) was investigated in the study of 11 normal volunteers. LSS was measured by having the subjects numerically rate a series of resistors; Steven's Psychophysical Law was used to evaluate sensitivity as the slope relating log (sensation) to log (stimulus). Peak pressure and actual added resistance were the stimuli. Inspiratory time, peak pressure, duty cycle, and tidal volume were inversely related to independently measured LSS during exercise and with a respiratory-type dead space and inspiratory resistance load. Because the need for changes in respiratory timing is a major adaptation in respirator use, it suggests that workers who are very sensitive to loads may have limited ability to adapt to respirator use.     

肠内营养支持对老年呼吸衰竭患者呼吸功能的影响

近 2 0年来 ,西方主要工业化国家在心脑血管病病死率大幅度下降的同时 ,慢性呼吸系统疾病却在明显增多 ,在我国的病因统计中 (1 994年 ) [1 ] ,呼吸系病也是城乡居民病残和病死的重大疾病 ,且随着人口老龄化的出现 ,老年患者呼吸衰竭 (呼衰 )的发病率逐年增加 ,因此老年呼衰患者的有效治疗成为大家逐渐关注的问题。我科对 2 0例老年呼衰患者在临床治疗的同时给予肠内营养支持 ,取得一定疗效。1　对　象　与　方　法1 .1　对象　　患者为我院内科危重病房监护室病人 ,全部病例均符合呼衰诊断标准 [2 ] ,其中实验组 2 0例 (男1 3 ,女 7) ,年龄…     

Relative chronic effects of different occupational dusts on respiratory indices and health of workers in three Ethiopian factories

The respiratory effects of dusts in different sections of yarn, cement, and cigarette factories were studied in 211 nonsmoking male and female workers aged 21–57 years. The controls used were 211 healthy nonsmoking and nonexposed male and female subjects aged 20–57 years from the general population. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV₁), FEV₁/FVC ratio, forced expiratory flow (FEF_{200–1,200 ml}), forced mid-expiratory flow (FMF_25–75%) and peak expiratory flow rate (PEFR) were recorded in all subjects with and without respiratory symptoms. Taking exposures to all dusts of different concentrations together, it was found that the frequency of respiratory illness was greater among exposed workers (40.5% in males, 36% in females) than it was among controls (21.6% in males,18% in females). In exposed subjects, the symptom prevalence was only 4.5% higher in males than in females.The mean lung function indices, including FEV₁, FEV_1%, FEF_{200–1,200 ml}, FMF_25–75%, and PEFR, in subjects exposed to all dusts in general decreased markedly, with dust concentration being more important than duration of exposure, and FMF being affected slightly more consistently. About 38.4% of the dust-exposed subjects developed corresponding respiratory illnesses including chronic cough (24.7%), chronic bronchitis (21.8%) and bronchial asthma (24.2%). The respective control values were 9.0%, 9.5%, and 8.5%. Exposure to different occupational dusts resulted in the development of respiratory illness with different rates of prevalence. The effects of exposure to cotton and cement dusts on respiratory health of exposed subjects were relatively more significant (p < 0.001) than that of exposure to tobacco dust (p < 0.05). Am. J. Ind. Med. 34:373–380, 1998. © 1998 Wiley-Liss, Inc.     

婴幼儿呼吸道感染中病毒检测的临床意义

目的：了解婴幼儿急性呼吸道感染的病原学构成及临床特征,探究更快缓解临床症状的治疗方案。方法选取年龄为3个月至3岁之间因急性呼吸道感染住院治疗的婴幼儿179例,采集每例患儿鼻咽吸取物1份,运用直接免疫荧光法检测7项呼吸道病毒抗原,并分析其结果。结果在179例送检标本中,阳性检出率为35．2％,其中呼吸道合胞病毒感染占阳性标本的52．4％。病毒检测阳性患儿临床症状体征更明显（t＝5．016,P＜0．01）。结论病毒是婴幼儿呼吸道感染的主要病原,以呼吸道合胞病毒最常见。     

检测SARS患者血清中抗-SARS-CoV IgG的四种试剂盒比较

目的比较4种试剂盒检测SARS患者血清中抗-SARS-CoX IgG的灵敏度和特异度。方法用2种酶联免疫吸附试验(EIA)和2种间接免疫荧光法(IFA)试剂盒分别检测18例SARS患者的99份系列血清及123份阴性参比血清标本中抗-SARS-CoV IgG。结果在患者发病第1周，4种试剂盒均未检出抗-SARS-CoX IgG；自发病第2周，除EIA甲未能检出外，EIA乙和2种IFA均从血清中检出抗-SARS-CoV IgG，其阳性率分别为57．1％(4／7)、57．1％(4／7)和42．9％(3／7)。4种试剂盒最早检出时间分别为发病后第16、12、13和9天。于发病后第3周该4种试剂盒的检出率分别为52．6％(10／19)、94．7％(18／19)、78．9％(15／19)和84．2％(16／19)。但自发病第4周后，该4种试剂盒的检出率相同。检测123份阴性参比血清表明，除EIA乙的特异度为94．9％外，其余3种试剂盒的特异度均为100％。结论2种IFA的灵敏度和特异度均较2种EIA高；2种国产EIA试剂盒质量尚需进一步提高。     

Prevalence of Respiratory Disease and Associated Factors in an Urban Area of Delhi

Objectives:

To study the prevalence of respiratory morbidity and its associated factors in urban Delhi.

Study Design and Setting:

A cross-sectional, house-to-house survey was conducted in an urban upper middle class locality.

Materials and Methods:

All the residents aged 18 years or more were administered a questionnaire to identify the major symptoms of chronic respiratory tract disease — chronic cough, chronic phlegm, dyspnea and wheezing. The prevalence of all these symptoms in different groups was calculated. Chi square test and logistic regression were applied to determine the significant factors.

Results:

A total of 3465 individuals were interviewed of which 1756 (50.68%) were males and 1709 (49.3%) were females. Only 9.05% of the men smoked. The overall prevalence of chronic cough, chronic phlegm and dyspnea was 2.0%, 1.2% and 3.4%, respectively. The prevalence of wheezing was 3.2%. All the symptoms increased with age (P < 0.05). No significant difference was observed in these symptoms between males and females. Less educated and retired individuals were more likely to have respiratory symptoms. The prevalence of chronic cough, chronic phlegm, dyspnea and wheezing was 5.8%, 2.9%, 9.9% and 8.7%, respectively, among smokers, which was significantly higher than that observed in nonsmokers. Logistic regression analysis revealed that age and smoking remained significant factors for occurrence of all the respiratory symptoms.     

一种全能型同步呼吸机的研制

介绍一种全能型同步呼吸机的设计及实现方法。该呼吸机采用单片机控制，硬件设计合理，软件编制模块化，具有功能全，性能强，临床监护参数多，可靠性高等特点，具有很好的应用前景。     

棉田喷洒溴氰菊酯对喷药人员健康影响的研究

连续两年对44名棉田喷洒2.5％溴氰菊酯的农民进行了健康调查。结果表明,当呼吸带空气中溴氰菊酯的浓度为0.022～24.070μg/m~3,同时皮肤表面的污染量为0.013～0.347μg/cm~2时,多数人主诉面部皮肤有烧灼和刺痒感觉,个别人还伴有粟粒样红色丘疹,但是没有观察到任何急性中毒表现。血液中Na~+、K~+、尿素氮、Na~++K~+-ATP酶、5-羟色胺和尿中5-羟吲哚乙酸、3-甲氧基-4-羟基苦杏仁酸以及其它观察指标,在两组之间均无明显差异。喷药人员尿中溴氰菊酯的含量低于0.20μg/L。     

2015 - 2017年上海市黄浦区成人急性呼吸道感染病例病原学监测分析

目的 探索上海市黄浦区成人急性呼吸道感染病例（ARI）的病原体感染分布特征。方法 采集黄浦区监测点369例急性呼吸道感染病例的呼吸道标本进行多重PCR以及细菌培养等检测,分析病原体感染的流行特征。结果 2015 - 2107年共收集了369例ARI病例,检出12种病原体,病原体检出阳性率为55.01%（203/369）。其中甲型流感病毒阳性率最高,为25.56%（98/369）,乙型流感病毒阳性率为9.76%（36/369）,肺炎克雷伯菌为4.61%（17/369）,鼻病毒/肠道病毒为3.79（14/369）。检出的病原体感染中混合感染率为5.42%（20/369）。不同年龄组感染率有所不同,16～24岁年龄组感染率较高（68.00%,17/25）,60岁及以上年龄组感染率较低（44.90%,66/147）。冬季和夏季是呼吸道病原体阳性率较高,检出阳性率分别为69.11%（85/123）、60.32%（76/126）。流感有季节性特征,夏季阳性率为17.34%（64/369）,冬季阳性率为14.36%(53/369）。结论 上海市黄浦区成人呼吸道感染病例中病原体主要以病毒为主,其中季节性流感检出阳性率最高。不同年龄组感染率有差异,冬季和夏季是呼吸道病原体感染流行的高峰。