双水平无创正压通气在急性有机磷农药中毒伴呼吸衰竭中的应用

目的 探讨双水平无创正压(BiPAP)通气对急性有机磷农药中毒伴呼吸衰竭患者的疗效.方法将44例急性有机磷农药中毒伴呼吸衰竭患者随机分为治疗组和对照组,对照组给予常规治疗,治疗组在常规治疗的基础上给予BiPAP机械通气.观察治疗前及治疗2、24、48h动脉血气及呼吸频率和心率变化,并比较气管插管率、病死率、住院时间、住院费用.结果BiPAP通气对提高PaO2和降低PaCO2与对照组比较差异有统计学意义(均P<0.05),治疗组插管率、病死率、住院费用比对照组明显降低(P<0.05).结论BiPAP机械通气辅助治疗急性有机磷农药中毒伴呼吸衰竭效果好.对改善患者呼吸通气功能优于对照组,并可明显减少插管率、病死率,降低住院费用.

Bilevel positive airway pressure ventilation in the patients with acute organophosphorus pesticides poisoning and respiratory failure

Objective To investigate the efficacy of bilevel positive airway pressure mechanical ventilation (BiPAP) in the patients of acute organophosphorus pesticides poisoning (AOPP) with respiratory failure. Methods 44 AOPP patients with respiratort failure were randomly divided into experimental group (n = 22) and control group (n = 22). The routine trentment was given to both groups, additional BiPAP assisted ventilation was given to the treatment group. Blood gas,heart rate and respiratory rate were detected before and 2 h,24 h,48 h after treatment, and the rote of intubatinn,mortality,duration and cost of hospitalization were compared between two groups. Results Heart rate,PaO2 was significantly increased and PaCO2 decreased in BiPAP ventilation (P <0. 05). The mortality,intubatien rate and cost of hospitalization were significantly decreased in BiPAP treatment group (P < 0. 05). Conclusion The BiPAP ventilation is certainly effective to acute organophosphorus pesticides poisoning with respiratory failure. It could obviously improve the clinical symptoms and arterial blood gas analysis, and could reduce the mortaiity, rate of intubotion,cost of hospitalization of patients of acute organophosphoms pesticides poisoning with respiratory failure.