无创正压通气在防治老年病人全身麻醉术后肺部并发症的应用

目的研究无创正压通气对老年病人全身麻醉术后肺部并发症的预防和治疗作用。方法将术前情况基本相同的40例全身麻醉术后的老年病人随机分为无创正压通气治疗组和对照组,治疗组为拔管后即应用无创正压通气,持续24h,其他处理与对照组相同;在术前,拔管时,拔管后05、2、8、24及48h监测动脉血气,比较术前、拔管后、24h后、48h后X线胸片及床旁肺活量的变化,观察肺部感染发生率、住院天数及不良反应。结果两组患者术后均出现低氧血症和高碳酸血症,部分患者发生肺不张。经24h无创正压通气治疗后,患者的动脉血气指标、肺活量和肺不张情况均较对照组明显改善(P<005),无创正压通气对术后疼痛有一定的缓解作用(P<005)。结论无创正压通气对老年病人全身麻醉术后的低氧血症、高碳酸血症和肺不张有较好的防治作用。

Application of noninvasive positive pressure ventilation in the prevention and treatment of pulmonary complication in senile postoperative patients with general anesthesia

Objective To study the effects of noninvasive positive pressure ventilation(NIPPV) in the prevention and treatment of pulmonary complication in senile postoperative patients with general anesthesia.Methods 40 senile patients after surgical operation and general anesthesia were randomly divided into NIPPV group and control group.Arterial blood gas analysis were performed in all patients before operation,at extubation and at 0.5 h,2 h,8 h,24 h,48 h after extubation.Chest radiograph and vital capacity were measured before operation,at extubation and at 24 h,48 h after extubation.The incidence of pulmonary infection,hospital days and adverse effects were observed simultaneously.Results Hypoxemia and hypercapnia occurreed in both two groups and atelectasis occurred in some cases.Arterial blood gas parameters and vital capacity in NIPPV group were better than those in control group.Meanwhile atelectasis was recovered promptly after NIPPV.Interestingly,postoperative pain was also alleviated obviously by NIPPV.Conclusion NIPPV could prevent and treat hypoxemia,hypercapnia and atelectasis of senile patient with general anesthesia after operation.