胸外伤后急性肺损伤的无创机械通气治疗效果观察

目的探讨应用多功能呼吸机无创通气治疗胸部外伤所致急性肺损伤ALI。方法对我院45例胸部外伤导致ALI患者进行前瞻性对照研究。观察无创通气组动脉血氧分压、氧合指数、呼吸频率及辅助呼吸肌动用评分,并对两组病死率、呼吸机并发症发生率、机械通气治疗时间及住院时间进行统计学分析。结果无创通气组动脉血氧分压、氧合指数较通气前均有明显改善（P〈0.05）,呼吸频率及辅助呼吸肌动用评分在通气后12 h及撤机后较通气前下降（P〈0.05）;无创通气组机械通气并发症发生率、机械通气治疗时间及住院时间优于有创通气组（P〈0.05）。结论无创机械通气是治疗胸部外伤所致急性肺损伤特别是恶化至急性呼吸窘迫综合征的有效方法。

Observation of dinieal effect of non-invasive ventilatory support in the treatment of patients with acute lung inju-ry caused by thoracic trauma

Objective To evaluate the effect of non-invasive ventilatory support （NIV） in the treatment of patients with acute lung injury （ALI） caused by thoracic trauma. Methods 45 ALl patients caused by thoracic trauma between were randomly divided into two groups. The observation group received NIV treatment and the control group received invasive mechanical ventilation （ IMV ） treat- ment. The level of PaO2 , ratio of PaO2/FiO2 , respiratory rate （RR） and score of the accessory respiratory muscle use after the treatment were compared and analyzed between the two groups. Results The improvement of PaO2 , PaO2/FiO2 , RR and score of the accessory re- spiratory muscle use increased more obviously in the observation group than in the control group after the treatment （ P 〈 0.05 ）. The inci- dence of ventilation complications and the duration of ventilation and hospital stay were lower in the observation group than in the control group （P 〈 O. 05 ）. Conclusion Non-invasive venti｜atory support is a very effective method for ALI patients caused by thoracic trauma, especially for those with acute respiratory distress syndrome.