急诊无创正压通气应用于急性呼吸衰竭治疗的临床研究

目的探讨在急诊科使用无创正压通气（NPPV）治疗急性呼吸衰竭的临床效果。方法对急诊科收治的急性呼吸衰竭患者47例，按照人院顺序及患者是否愿意进行呼吸机治疗分为NPPV治疗组24例与标准治疗组23例，标准治疗组进行常规治疗，NPPV组在常规治疗的基础上在具有上呼吸机指标的情况下面罩连接呼吸机辅助通气治疗。观察两组患者治疗前后呼吸频率（HR）、心率（RR）、二氧化碳分压（PaCO2）、氧合指数（PaO2/FO2）、pH值变化及治疗转归。结果两组患者治疗2h、24h后HR、RR、PaC02下降，PaO2／FO2、pH值上升，NPPV组以上各项指标治疗前后比较差异有统计学意义（P〈0．05），标准治疗组仅治疗24h后PaCO2、PaO2／FO2、pH值与治疗前比较差异有统计学意义（P〈0．05）。标准治疗组经过治疗后存活14例（60．87％），9例（39．13％）患者最终死亡；NPPV组经过治疗最终存活21例（87．50％），3例（22．50％）死亡。标准治疗组平均住院时间（24．45±12．13）d，NPPV组平均住院时间（16．64±9．87）d。结论急诊科应用NPPV治疗急性呼吸衰竭能快速改善患者通气情况，提高患者存活率。

Clinical research on application of acute noninvasive positive pressure ventilation in treatment of acute respiratory failure

Objective To explore the clinical application effect and value of acute noninvasive positive pressure ventilation （NPPV） in treatment of acute respiratory failure （ARF） in the emergency department. Methods 47 patients with ARF by all causes were divided into two groups, according to the order and whether they were willing to breathing machine treatment. 24 patients in NPPV group, and standard therapy group with 23 cases, standard treatment group used the routine treatment, based on routine therapy in the breathing machine, NPPV group was treated with index of the mask breathing machine under connection assisted ventilation treatment. We observed both groups before and after treatment the heart rate （HR）, respiratory rate （RR）, carbon dioxide points pressure （PaCO2）, oxygen and index （PaO2/FO2）, pH value change, the treatment outcome. Results HR, RR, PaCO2, PaO2/FO〉 and pH value examination results before treatment standard treatment group and group compared with those of NPPV there was no statistical difference （P〉0.05）, two groups＇ HR, RR, PaCO2 2 h, treatment within 24 h before testing results and the treatment was down, PaO2/FO2, pH value rised, NPPV group above index before and after treatment there was statistical differences （P〈0.05）, standard treatment group within 24 h PaCO2 only treatment, PaO2/FO2, pH value andtreatment before there was statistical difference （P〈0.05）. Standard treatment group had survival rate by 60.87%, the death rate 39.13%, and the average hospitalization time （24.45 ± 12.13） d, NPPV group survival rate by 87.50%, the death rate 22.50%, and the average hospitalization time （16.64 ± 9.87）d, two groups in the length of time and the survival rate of the patients, there was statistical significant difference （P〈0.05）. Conclusion The acute NPPV application in treatment of ARF can quickly improve patients＇ ventilation condition, and increase their survival rate.