序贯性机械通气在急性有机磷农药中毒并发呼吸衰竭患者的应用

目的观察急性有机磷农药中毒（AOPP）并发呼吸衰竭患者应用序贯性机械通气的价值。方法选择AOPP并发呼吸衰竭患者78例,随机分成序贯治疗组（38例）和对照组（40例）,在综合治疗基础上,序贯治疗组依次应用BiPAP-A/C-SIMV或SIMV＋PSV-BiPAP或PSV＋PEEP通气模式,对照组应用A/C-SIMV模式。结果序贯治疗组有创通气时间、总机械以爱气时间、以生呼吸机相关性肺炎（VAP）、撤机失败、住院时间及病死率与对照组比较差异均有统计学意义（P〈0.05）。结论AOPP并发呼吸衰竭患者采用无创-有创-无创通气是治疗呼吸衰竭有效方法之一,能明显降低呼吸机肺炎（VAP）发生率及病死率,缩短有创通气及住院时间,减少撤机失败。

The study of sequebtial mechanical ventilation in the patients with acute organophosphorus pesticide poisoning with respiratory failure

Objective To study the appliction value of sequential mechanical ventilation in the patients with acute organophosphorus pesticide poisoning（AOPP） and respiratory failure（RF）. Methods 78 patients of AOPP with RF were randomly divided into sequential therapy group（ n = 38 ）and the control group （n = 40 ）. The sequential therapy group chose BiPAP - A/C-SIMV or SIMV ＋ PSV-BiPAP or PSV ＋ PEEP ventilation, and the control group chose A/C-SIMV ventilation. Results There were significant differences in invesive ventilation time, the length of hospitalization and mortality between sequential treatment group and the control group （ P 〈0. 05 ）. Conclusion Noninvasive-invasive-noninsive ventilation is effective treatment for AOPP patients with RF, it can significantly shorten the time of invasive ventilation, the length of hospitalization and reduce the incidence of VAP, weaning failure and the mortality.