摘要
目的了解无创正压通气(NIPPV)联合支气管镜吸痰在重症社区获得性肺炎治疗中的价值。方法重症社区获得性肺炎60例随机分为对照组和观察组,每组30例。对照组在常规治疗的基础上使用无创正压通气治疗,观察组在对照组的基础上加用纤维支气管镜吸痰治疗,根据治疗前后动脉血血气分析和完全脱离无创呼吸机时间等指标比较两组的疗效。结果治疗后24、48 h观察组的p H值与对照组比较差异有统计学意义(P<0.05);动脉血氧分压(Pa O2)和氧合指数(Pa O2/Fi O2)在治疗后4个时段与对照组比较差异也有统计学意义(P<0.01);动脉血二氧化碳分压(Pa CO2)在治疗后12 h明显高于对照组(P<0.01)。观察组、对照组因病情加重行气管插管术者分别有3、12例,两组比较差异有统计学意义(P<0.05)。观察组完全脱离无创呼吸机时间和住院时间均比对照组明显缩短(P<0.01)。结论 NIPPV联合支气管镜吸痰治疗重症社区获得性肺炎能迅速改善酸碱平衡,缩短脱离无创呼吸机时间和住院时间,提高抢救的成功率。
Objective To understand the values of non-invasive positive pressure ventilation（NIPPV） combining bronchoscopic sputum suction on the treatment of severe community-acquired pneumonia. Methods 60 cases with severe community-acquired pneumonia were randomly divided into Control Group and Observation Group, 30 cases in each group. Control Group was treated with NIPPV on the basis of routine treatment. Observation Group was treated with bronchoscopic sputum suction on the basis of the treatment for Control Group. The curative effect of the two groups before and after treatment was compared according to the indicators such as blood gas analysis of arterial blood and time for completely without noninvasive ventilation. Results There was statistical difference between Observation Group and Control Group in terms of blood power of hydrogen（p H） 24 hours and 48 hours after treatment（P〈0.05）; There was also statistical difference between Observation Group and Control Group at four timeframe after treatment in terms of arterial oxygen pressure（Pa O2） and oxygenation index（Pa O2/Fi O2）（P〈0.01）; Pa CO2 in Observation Group was significantly higher than that of Control Group 12 h after treatment（P〈0.01）. There were 3 and 12 cases who underwent endotracheal intubation due to aggravation in Observation Group and Control Group, respectively, and there was statistical difference between the two groups（P〈0.05）. Observation Group had a significantly short time of being without non-invasive ventilation and hospital stay compared with Control Group（P〈0.01）. Conclusion Treating severe community-acquired pneumonia with NIPPV combining bronchoscopic sputum suction can rapidly improve the acid-base balance and shorten the time for being without noninvasive ventilation and hospital stay, and raise the success rate of rescue.
出处
《广东医学院学报》
2015年第4期448-451,共4页
Journal of Guangdong Medical College
关键词
无创正压通气
支气管镜
吸痰
重症社区获得性肺炎
non-invasive positive pressure ventilation
bronchoscope
sputum suction
severe community-acquired pneumonia
