应用机械通气救治急性药物中毒并急性呼吸衰竭

目的观察早期应用机械通气对急性药物中毒患者并发急性呼吸功能不全和急性呼吸功能衰竭的影响。方法对40例急性药物中毒患者均在确诊为急性呼吸功能不全和衰竭后立即给予机械通气,并动态监测机械通气前和机械通气后30min、1h、12h、24h、48h、72h和脱机前动脉血气。通过统计学分析比较不同时期的动脉血气分析结果。结果所有患者在机械通气12h后,低氧血症均有不同程度的改善,34例患者在机械通气后48h低氧血症均明显改善,36例患者72h后动脉血气均恢复正常。与上机前相比均有非常显著性差异(P<0.01)。结论急性药物中毒并发呼吸衰竭患者,对于病因的治疗虽至关重要,但呼吸功能的支持和监测是预后的关键。因此,适当放宽机械通气指征,尽早给予机械通气,有利于防治因急性呼吸功能不全引发的多脏器功能障碍综合征,提高急性药物中毒救治成功率,降低其死亡率。

The Application Value of Mechanical Ventilation on Remedying Acute Drugs Poisoning Complicating Acute Respiratory Failure

Objective To observe the effect of applicating mechanical ventilation on remedying acute drugs poisoning complicating acute respiratory insufficiency(ARI) and acute respiratory failure(ARF) at earlier period.Methods 40 patients with acute drugs poisoning complicating ARI and ARF received mechanical ventilation,and monitored arterial blood gas(ABG) at dynamic state before mechanical ventilation,when 30 min,1h,12h,24h,48h,72h after mechanical ventilation and before off-line.Compared the result of ABG at different periods by using statistics.Results The symptom of hypoxemia(HXA) for all patients had amended at different degree at 12h after mechanical ventilation.The symptom of HXA for 34 patients had amended abviously at 48h after mechanical ventilation.The ABG for 36 patients had recovered normally at 72h after mechanical ventilation.There is highly significant difference compared with before mechanical ventilation(P<0.01).Conclusion The therapy for etiopathogenisis was very important for the patients with acute drugs poisoning complicating ARF,but the support and monitoring on respiratory function was key point for prognostic.So lossoning the indication for mechanical ventilation properly and providing mechanical ventilation early was profit for preventing and curing the MODS which was caused by ARI,and also can elevate remedy achievement radio and degrade mortality rate.