无创呼吸机鼻罩面罩通用头带应用效果评价

[目的]探讨无创呼吸机鼻罩面罩通用头带的应用效果。[方法]采取单纯随机抽样的方法，将病人分为两组，观察组应用无创呼吸机鼻罩面罩通用头带；对照组采用传统头带，对两组病人鼻罩或面罩固定效果、头带成本、病人满意度及护士操作时间等进行比较。[结果]两组病人鼻罩或面罩固定效果、头带成本、病人满意度及护士操作时间比较，观察组显著优于对照组（P〈0．01）。[结论]无创呼吸机鼻罩面罩通用头带固定效果好，病人满意度高，护士操作时间缩短，且医疗成本低。     

鼻罩和面罩在慢性阻塞性肺疾病加重期无创通气中的疗效对比

目的　比较鼻罩和面罩在慢性阻塞性肺疾病 (COPD)加重期患者无创通气中的疗效。方法　 5 0例患者随机分为鼻罩组和面罩组 ,通气 2h ,比较通气效果、鼻 /面罩的舒适度和预后。结果　两组通气后临床症状和动脉血气均明显改善。面罩组二氧化碳分压降低更显著 (面罩组 6 3 2± 7 3mmHg ,鼻罩组 6 9 2± 6 5mmHg ,P <0 0 5 )。患者对鼻罩的耐受程度显著高于面罩 ,鼻罩的舒适度评分 (5 6 8± 1 6 3)也明显优于面罩 (4 4 0± 2 10 )。两组的插管率、住院时间和病死率无显著差异。结论　鼻罩和面罩通气对COPD患者的疗效和预后相似 ,面罩能较快降低二氧化碳分压 ,而鼻罩更舒适 ,更易被患者接受。     

介绍一种无创通气口鼻面罩固定带的制作与应用

无创通气(Noninvasive Ventilation,NTV)是指不经人工气道(气管插管或气管切开)进行的通气。 目前使用的面罩固定带易松动移位而致漏气,持续漏气使通气量下降影响治疗效果。为此我院对头部固定带进行了改进,经临床观察使用30例,治疗效果显著,现介绍如下。 1 材料与制作     

无创呼吸机鼻罩面罩通用头带应用效果评价

[目的]探讨无创呼吸机鼻罩面罩通用头带的应用效果。[方法]采取单纯随机抽样的方法,将病人分为两组,观察组应用无创呼吸机鼻罩面罩通用头带;对照组采用传统头带,对两组病人鼻罩或面罩固定效果、头带成本、病人满意度及护士操作时间等进行比较。[结果]两组病人鼻罩或面罩固定效果、头带成本、病人满意度及护士操作时间比较,观察组显著优于对照组(P<0.01))。[结论]无创呼吸机鼻罩面罩通用头带固定效果好,病人满意度高,护士操作时间缩短,且医疗成本低。     

无创机械通气鼻罩与口鼻罩在呼吸衰竭病人中应用效果对比研究

[目的]对经鼻罩无创机械通气与经口鼻罩无创机械通气在呼吸衰竭病人中应用效果进行对比。[方法]将84例呼吸衰竭需用无创呼吸机辅助治疗病人随机分为用鼻罩组和用口鼻罩组各42例,比较采用鼻罩和口鼻罩通气前和通气后30min的血气分析指标和病人配合情况。[结果]无创机械通气治疗及护理后30min,鼻罩组与口鼻罩组病人动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、pH值比较差异有统计学意义(P0.05)。且鼻罩组配合情况明显优于口鼻罩组(P0.05),且两组病人配合情况方面比较差异有统计学意义(P0.05)。[结论]经鼻罩无创机械通气治疗呼吸衰竭疗效满意,经鼻罩无创机械通气病人的配合率更高。     

面罩与鼻罩在无创呼吸治疗AECOPD并发呼吸衰竭患者中的疗效对比

目的：探讨面罩与鼻罩在无创呼吸治疗AECOPD合并呼吸衰竭患者中的疗效对比。方法：将100例AECOPD患者并发呼吸衰竭的患者随机分为无创呼吸面罩治疗组（n=50）,鼻罩治疗组（n=50）。观察两组疗效：血气24hPH、PaO2、PaCO2、总有效率及住院时间、不良反应。结果：面罩治疗组与鼻罩治疗组在疗效、血气指标、心率、呼吸及住院时间无差异,但在不良反应方面,鼻罩组明显较面罩组减少。结论：对于AECOPD并发有呼吸衰竭的患者,在临床上更易优先推广鼻罩在无创呼吸中应用。     

经鼻（面）罩无创通气治疗COPD呼吸衰竭疗效探讨

经鼻(面)罩无创机械通气因其无创,能有效避免气管苘插管,在救治慢性阻塞性肺疾病(COPD)中发挥越来越重要的作用.作者对COPD呼吸衰竭患者24例接受BiPAP(bilevel positive airway pressure)呼吸机与传统氧疗方法进行比较,评价其疗效和优越性.     

改良无创呼吸机面罩在心脏术后无创通气治疗患者中的应用

目的 探讨改良无创呼吸机面罩在心脏术后患者无创通气的应用效果.方法 2019年12月至2020年8月,便利抽样法选取某三级甲等医院胸外科92例心脏术后需无创通气的患者为使用对象,按入院时间先后顺序将其分为对照组和观察组,每组各46例患者.观察组使用改良无创呼吸机面罩,氧气驱动雾化吸入的同时进行无创通气;对照组使用常规面...     

鼻塞与鼻罩在新生儿无创通气中的应用及护理进展

鼻塞与鼻罩是目前应用最广泛的新生儿无创通气的连接界面。短的双鼻塞对新生儿鼻腔施加最小的外部压力,增强患儿的舒适感,有利于鼻黏膜的保护,更有利于减少气管插管,但长时间应用短的双鼻塞易导致鼻孔和鼻中隔损害。近年来应用的软硅鼻罩,无效腔较小,对鼻孔无刺激,不压迫鼻中隔,易与鼻部气道贴合,密封性好,但长时间应用也会损害鼻唇沟等鼻部周围皮肤。鼻塞或鼻罩导致鼻部损伤的发生率基本相似,但导致鼻部损伤的部分不同。在使用过程中针对易出现的问题采取选择合适大小的鼻塞、鼻罩、帽子和精心护理等综合性措施预防,可以减轻鼻部损伤。先使用鼻罩,72 h后与鼻塞轮换使用,可以提高无创通气的疗效,进一步减少鼻部损伤的发生。     

Controlled trial of oronasal versus nasal mask ventilation in the treatment of acute respiratory failure

OBJECTIVE: Noninvasive positive pressure techniques such as continuous and bilevel positive airway pressure avoid intubation and its attendant complications in selected patients with acute respiratory failure. However, mask intolerance remains a common cause for failure of noninvasive ventilatory techniques. The aim of our study was to assess patient tolerance of oronasal vs. nasal mask ventilation in acute respiratory failure. DESIGN: Randomized, controlled trial. SETTING: Emergency department or intensive care units at a university hospital. PATIENTS: Seventy patients with acute respiratory failure as evidenced by clinical or blood gas criteria. INTERVENTIONS: Patients randomly received either a disposable nasal or an oronasal mask (Respironics, Pittsburgh, PA) when they met study criteria. MEASUREMENTS AND MAIN RESULTS: Thirty-five patients were randomized into each arm of the study; most of the patients had acute cardiogenic pulmonary edema (48.6% of the nasal mask group and 42.8% of the facial mask group) or chronic obstructive airway disease (34.3% of the nasal mask group and 31.4% of the facial mask group). Baseline clinical characteristics of the two groups of patients were similar. Heart and respiratory rates and blood gases improved similarly for patients in both mask groups. Rates of intubation were also similar (eight in each group). However, mask intolerance was significantly higher in the nasal than the oronasal mask group (12 vs. 4, respectively, p=.023). Four patients in the nasal (11.4%) and two in the oronasal mask group (5.7%) died later during the hospitalization. The overall success rate tended to be greater in the oronasal (65.7%) than the nasal group (48.6%), but the difference was not statistically significant. CONCLUSION: Although both masks performed similarly with regard to improving vital signs and gas exchange and avoiding intubation, the nasal mask was less well tolerated than the oronasal mask in patients with acute respiratory failure.     

早期康复护理对脑出血微创术后病人神经功能的影响

脑出血是常见病和多发病。占各类型脑卒中的20％-30％，是病死率和致残率最高的脑卒中类型。脑出血术后的高致残率是临床面临的重要挑战，三级康复治疗在改善脑卒中病人的预后和提高病人的生存质量方面有重要意义。因此，我们在以往研究脑出血的基础上，选择2002年10月-2007年12月100例行微创手术治疗的脑出血病人，通过临床随机对照实验，探讨早期康复治疗对脑出血病人神经功能和日常生活能力的影响。     

Effects of face mask ventilation in apneic patients with a resuscitation ventilator in comparison with a bag-valve-mask

Bag-valve-mask ventilation in an unprotected airway is often applied with a high flow rate or a short inflation time and, therefore, a high peak airway pressure, which may increase the risk of stomach inflation and subsequent pulmonary aspiration. Strategies to provide more patient safety may be a reduction in inspiratory flow and, therefore, peak airway pressure. The purpose of this study was to evaluate the effects of bag-valve-mask ventilation vs. a resuscitation ventilator on tidal volume, peak airway pressure, and peak inspiratory flow rate in apneic patients. In a crossover design, 40 adults were ventilated during induction of anesthesia with either a bag-valve-mask device with room air, or an oxygen-powered, flow-limited resuscitation ventilator. The study endpoints of expired tidal volume, minute volume, respiratory rate, peak airway pressure, delta airway pressure, peak inspiratory flow rate and inspiratory time fraction were measured using a pulmonary monitor. When compared with the resuscitation ventilator, the bag-valve-mask resulted in significantly higher (mean+/-SD) peak airway pressure (15.3+/-3 vs. 14.1+/-3 cm H2O, respectively; p=0.001) and delta airway pressure (14+/-3 vs. 12+/-3 cm H2O, respectively; p<0.001), but significantly lower oxygen saturation (95+/-3 vs. 98+/-1%, respectively; p<0.001). No patient in either group had clinically detectable stomach inflation. We conclude that the resuscitation ventilator is at least as effective as traditional bag-valve-mask or face mask resuscitation in this population of very controlled elective surgery patients.     

高血压性脑出血病人微创颅内血肿清除术后的护理

目的探讨高血压性脑出血病人微创颅内血肿清除术后的护理。方法对21例高血压脑出血病人行微创颅内血肿清除术,术后严密观察病情并控制血压做好创腔引流及脑室引流的护理,保持呼吸道通畅,保证正确的体位及大小便通畅,预防并发症。结果完全恢复生活自理5例（其中重返工作岗位3例）;部份生活自理6例;需人帮助扶拐可走8例;植物状态1例;死亡1例。结论对高血压性脑出血病人采用科学的护理方法,可保证手术治疗效果,提高抢救成功率,降低病死率和致残率,提高了病人的生存质量。     

Godoy & Godoy technique of cervical stimulation in the reduction of edema of the face after cancer treatment

The estimated number of cases of cancer of the lips and mouthin Brazil in 2007 was 10 380 among men and 3780 among women.¹Of the cancers of lips and mouth (buccal mucous membranes, gum,hard palate, tongue and mouth floor), lip cancer is the mostcommon in Caucasians.¹ Cancer of the other regions of the mouthmainly affect over 40-year-old men, in     

Mechanical ventilation in fiberoptic-bronchoscopy: comparison between high frequency positive pressure ventilation and normal frequency positive pressure ventilation

High frequency positive pressure ventilation (HFPPV) was compared with normal frequency positive pressure ventilation (NFPPV) during diagnostic fiberoptic-bronchoscopy. HFPPV was achieved by a simple modification of the Minivent, and gave satisfactory alveolar ventilation and oxygenation. In all 11 patients and over periods of at least 40 min, HFPPV gave normal PaCO2 and high levels of PAO2. Arterial blood pressures were higher and the airway pressures were lower than during NFPPV.     

Clinical outcome and quality of life after interventional treatment of left main disease with drug-eluting-stents in comparison to CABG in elderly and younger patients

Introduction  

The aim of this study was to prospectively assess the clinical outcome and quality of life of elderly patients who underwent either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for treatment of significant left main disease (LMD) compared to a younger patient population.     

肺复张在呼吸窘迫综合征机械通气患者吸痰后的应用观察

目的观察呼吸窘迫综合征（ADRS）患者在吸痰后应用肺复张法的效果。方法选择38例进行机械通气的ARDS患者,随机分为观察组和对照组,两组机械通气过程中,吸痰方法相同,观察组在吸痰完毕连接呼吸机后立即给予一次肺复张,观察两组患者吸痰前后动脉血气分析指标和氧代谢指标;吸痰前、中、后血流动力学指标的意义及吸痰后SpO2恢复至吸痰前水平所需时间。结果两种方式吸痰前后血流动力学指标差异无显著意义（P〉0．05）;对照组患者PaO2、SaO2、SpO2较吸痰前显著降低（均P〈0．01）。观察组吸痰前后各项指标比较,差异无显著性意义,（P〉0．05）;SpO2恢复吸痰前水平,观察组显著短于对照组（P〈0．01）。结论肺复张能复张塌陷的肺泡,减少吸痰导致的缺氧血症对机体的危害。吸痰后给予肺复张对血流动力学未受到影响,无并发症,安全可靠。