早期机械通气救治急性中毒导致呼吸衰竭临床疗效观察

目的观察并探讨早期机械通气救治急性中毒导致呼吸衰竭临床疗效及安全性。方法回顾性分析某院2006年3月～2010年5月急诊科收治急性中毒导致呼吸衰竭患者47例临床抢救资料,其中24例患者在呼吸停止后5min内行气管插管机械通气,设为对照组;23例患者在自主呼吸存在条件下,依据昏迷、发绀等临床症状以及呼吸监测指标,早期给予气管插管机械通气,设为实验组;评价临床痊愈率,呼吸机使用时间及并发症发生情况。结果对照组与实验组患者临床痊愈率分别为70.8%、100%;实验组患者临床痊愈率明显高于对照组,两组间比较差异有统计学意义(P﹤0.05);对照组及实验组患者呼吸机使用时间分别为(82.5±10.5)h、(53.1±7.6)h;实验组患者呼吸机使用时间明显少于对照组,两组间比较差异有统计学意义(P﹤0.05);同时对照组与实验组患者肺部感染发生率分别为为87.5%、60.7%;对照组与实验组患者低血压发生率分别为16.7%、4.3%;实验组患者肺部感染及低血压发生率均明显低于对照组,两组间比较差异有统计学意义(P﹤0.05)。结论早期机械通气救治急性中毒临床效果确切,可以有效提高抢救成功率,降低机械通气相关并发症发生率,具有临床推广使用价值。

Observation of Clinical Therapeutic Effect of Respiratory Failure Caused by Acute Poisoning with Mechanical Ventilation in Early Stage

OBJECTIVE To observe and investigate the clinical therapeutic effect and security of respiratory failure caused by acute poisoning with mechanical ventilation in early stage. METHODS The clinical rescue data of 47 patients with respiratory failure caused by acute poisoning were analyzed retrospectively. The control group included 24 patients receiving endotracheal intubation within 5 min after the cessation of breathing,and the experimental group included 23 patients receiving early mechanical ventilation according to clinical symptoms and respiratory monitoring indicators in the presence of the spontaneous breathing. RESULTS The clinical cure rate of control group and experimental group were 70.8% and 100%,respectively;The clinical cure rate of experimental group were significantly higher than control group(P﹤0.05). The ventilator using time of control group and experimental group were(82.5±10.5)h and(53.1±7.6)h,respectively. The ventilator using time of experimental group was significant lower than control group(P﹤0.05);The incidence of pulmonary infection and low blood pressure of experimental group was significant lower than that of control group(P﹤0.05). CONCLUSION The respiratory failure caused by acute poisoning with mechanical ventilation in early stage possessed excellent clinical therapeutic effect,effectively increased the cure rate of rescue and reduced the incidence of ventilator-associated complications.