无创正压通气治疗创伤性湿肺的临床研究

目的 观察无创正压通气（NIPPV）治疗创伤性湿肺的疗效。方法 选择30例行无创正压通气治疗的创伤性湿肺患者为治疗组，24例未用NIPPV治疗的创伤性湿肺患者为对照组，通过对2组患者进行心电监测、血氧饱和度、呼吸频率、血气分析等指标的监测，比较2组患者呼吸频率和动脉血气参数、肺部病变吸收时间、气管插管率、ICU住院时间及预后。结果 30例创伤性湿肺患者经NIPPV治疗后动脉血气指标与临床表现明显改善（P〈0．01）；与对照组相比，NIPPV治疗组患者临床症状改善时间、肺部病变吸收时间、ICU住院时间明显缩短（P〈0．01），肺实变率显著减低（P〈0．05），但2组患者气管插管率和病死率差异却无显著性。结论 NIPPV通过调节压力支持与呼吸末正压水平，早期应用可明显改善创伤性湿肺患者病情及缩短病程，但并不能改善其预后。

Clinical study of noninvasive positive pressure ventilation in trauma patients with acute respiratory distress syndrome

Objective To evaluate the clinical efficacy of noninvasive positive pressure ventilation (NIPPV) in treating trauma patients with acute respiratory distress syndrome (ARDS). Methods 30 trauma patients with ARDS were treated with NIPPV and 24 trauma patients with ARDS were not .The changes of respiratory frequency, blood gas index, absorption time of lung lesion, endotracheal intubation times, the time of staying in ICU and prognosis were observed through monitoring ECG, blood oxygen saturation and respiratory frequency and blood gas analysis. Results The clinical symptoms and arterial blood gas parameters were improved significantly after NIPPV in 30 cases (P<0.01). The absorption time of moist lung and the time staying in ICU were shortened significantly after NIPPV (P<0.01)and the changes of lung were decreased(P<0.05).However, the rate of endotracheal intubations and mortality rate were not improved. Conclusion NIPPV may shorten the admission duration of trauma patients with ARDS through adjusting pressure support and end-respiratory positive pressure level, but it may not improve the prognosis of the traumatic patients with ARDS.