有创——无创序贯通气治疗IMS合并ARF

目的:探讨有机磷中毒中间期肌无力综合征并发呼吸衰竭患者有创-无创序贯辅助机械通气治疗的临床疗效。方法:对46例有机磷中毒中间期肌无力综合征并发呼吸衰竭患者全部气管插管进行有创通气治疗,随机分组,治疗组23例在呼吸功能恢复、通气氧合好转后提前拔除气管导管加用NIPPV间断治疗直至完全脱机;对照组23例是在满足撤机拔管的条件下脱机拔除气管插管;记录住院天数、总机械通气时间(h)、有创通气时间(h)、住EICU天数、呼吸机相关肺炎(VAP)例数再插管率等指标,比较其疗效。结果:治疗组在住院天数、住EICU天数及总机械通气时间(h)明显短于对照组(P<0.05),有创通气时间(h)显著短于对照组(P<0.01),在呼吸机相关肺炎(VAP)例数上显著少于对照组(P<0.01),相对于对照组治疗费用明显减少(P<0.05)。相对于对照组再插管率,2组比较无显著性差别结论:有机磷中毒中间期肌无力综合征并发呼吸衰竭患者进行有创-无创序贯辅助机械通气是抢救有机磷中毒中间综合征并发呼吸衰竭患者安全有效的治疗方法。

Clinical analysis of invasive and noninvasive sequential ventilation treatment in ophosphate poisoning middle amyosthenia syndrome with respiratory failure

Objective: To investigate the clinical efficiency of invasive and noninvasive sequential ventilation treatment in organophosphate poisoning middle amyosthenia syndrome with respiratory failure.Methods: 46 patients of organophosphate poisoning middle amyosthenia syndrome with respiratory failure were randomly divided into two groups,all were applicated with tracheal intubation invasive ventilation.23 cases in the treatment group were wiped out the endotracheal tube ahead of time after the breath function restored and the ventilation oxygenate changed for better,to add with NIPPV treats interrupted until completely off line.22 cases in the observation group were removed machine and wiping out trachea cannula under the satisfied conditions of offline extubation.We recorded the number of hospitalization days,the duration of mechanical ventilation(h),invasive ventilation(h),living in EICU days,ventilator-associated pneumonia(VAP),the number of re-intubation rate,and other indicators the efficacy of which was compared.Results: In the treatment group,the number of hospitalization days,living in EICU days and the duration of mechanical ventilation(h) was shorter than those in the control group obviously(P<0.05),invasive ventilation(h) was significantly shorter than that of the control group(P<0.01),ventilator associated pneumonia(VAP) on the number of cases was significantly lower than that of the control group(P<0.01).Compared to the control group the re-intubation rate increased significantly(P>0.05).Conclusion: The application of invasive noninvasive sequential ventilation treatment in organophosphate poisoning middle amyosthenia syndrome with respiratory failure was a safe and effective method for rescuing the cases of organophosphate poisoning.