艾滋病合并肺孢子菌肺炎所致呼吸衰竭应用无创正压通气疗效观察

目的 探讨双水平无创正压通气（BiPAP）对艾滋病肺孢子菌肺炎（PCP）所致呼吸衰竭的临床疗效.方法 2012年1月～2013年5月期间,在我院诊治的48例HIV感染者中,对因肺孢子菌肺炎所致的呼吸衰竭的患者按照是否接受BiPAP治疗分为常规治疗组（药物＋鼻/面罩吸氧治疗）和BIPAP治疗组（药物＋BiPAP治疗）,对治疗48h后两组PaO2,呼吸频率（P）,以及住院时间、血清白蛋白变化、病死率进行比较.结果 与常规治疗组相比,治疗48h后BiPAP治疗组PaO2明显升高,P明显降低,P＜0.05;并且2~4周后BIPAP治疗组血清清蛋白明显改善,住院时间明显缩短,病死率显著降低,P＜0.05.结论 对于HIV感染者发生合并PCP及呼吸衰竭,BiPAP治疗能够显著改善患者的低氧血症、呼吸功能和降低身体能量消耗,从而改善患者的预后.

The efficacy observation of noninvasive positive pressure ventilation in treatment of respiratory failure caused by pneumocystis pneumonia in AIDS patients

Objective To study the clinical efficacy of noninvasive positive pressure ventilation in treatment of respiratory failure caused by Pneumocystis pneumonia in AIDS patients. Methods 48 cases with respiratory failure caused by Pneumocystis pneumonia in AIDS patients in our hospital during the period from Jan 2012 to Mar 2013 were divided into the conventional therapy group （ Drug ＋ nasal / mask oxygen therapy） and the BIPAP therapy group （ Drug ＋ BIPAP therapy） according to accept the BI- PAP therapy or not. The arterial partial pressure of oxygen （PaO2 ） ,Respiratory rate（P） after treating 48 hours, and the hospitali- zation time, Changes in serum albumin, mortality in the two groups were observed and compared. Results compared with the conventional group, the PaO 2 was significantly increased and the rate of respiratory was obviously decreased after treating 48 hours in the BiPAP group, P 〈 0. 05 ; In addition, the level of serum albumin was improved, hospitalization time was obviously reduced and the mortality were significantly decreased, P 〈 0. 05. Conclusion For respiratory failure caused by Pneumocystis pneumonia in AIDS patients, the treatment of noninvasive positive pressure ventilation can significantly improve hypoxemia , respiratory func- tion and reduce body energy consumption, so improve the prognosis of patients.