Clinical Efficacy of Non-invasive Positive Pressure Ventilation in the Treatment of Early Acute Respiratory Failure in the Prone Position
王力傲 1张磊 1王梅英 1李争俏 1侯云生1
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作者信息
1. 050082 石家庄,联勤保障部队第九八○医院急诊医学科
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摘要
目的 探究急性呼吸衰竭患者早期应用俯卧位无创正压通气的临床效果.方法 采用便利抽样方法,选取2021年3月至2024年3月收治的急性呼吸衰竭患者100例为研究对象,按随机数字表法分为A组和B组,每组各50例.A组50例接受俯卧位无创正压通气方式,B组50例接受仰卧位无创正压通气方式.分析不同通气方式在早期急性呼吸衰竭患者中的临床效果,分析2组治疗0、12、24h血流动力学指标[心率、平均动脉压(MAP)]、呼吸功能监测指标[呼吸频率、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、血氧饱和度(SpO2)]、氧合指数及pH值的变化;比较2组治疗效果(24 h内气管插管率、病死率及并发症发生率),分析患者入院到开始俯卧位无创正压通气时间与无创正压通气总时间的相关性.结果 A组心率、MAP、呼吸频率、PaCO2均呈下降趋势,PaO2、SpO2、氧合指数均呈上升趋势,且2组间比较差异均有统计学意义(P＜0.05,P＜0.01).2组入院0、12、24 h pH值比较差异无统计学意义(P＞0.05);A组入院24 h内气管插管率、病死率、并发症发生率均低于B组(P＜0.05);患者入院到开始俯卧位无创正压通气时间与无创正压通气总时间有显著相关性(r=0.34,P＜0.01).结论 急性呼吸衰竭患者早期应用俯卧位无创正压通气,可显著改善血流动力学、呼吸功能、氧合指数等相关指标,效果明显.
Abstract
Objective To explore the clinical effect of non-invasive positive pressure ventilation(NIPPV)in the prone position in patients with acute respiratory failure(ARF).Methods A total of 100 patients with ARF admitted from March 2021 to March 2024 were selected as the research subjects by convenience sampling method and divided into group A(n=50)and group B(n=50)by random number table method.Group A received NIPPV in the prone position,group B received NIPPV in the supine position.Clinical effects of different ventilation modes in patients with early ARF were analyzed.The changes in hemodynamic indexes[heart rate(HR),mean arterial pressure(MAP)],respiratory function monitoring indexes[re-spiratory rate,arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),blood oxygen satu-ration(SpO2)],oxygenation index and pH value of the two groups were analyzed at 0,12 and 24 h after treatment were ana-lyzed.The therapeutic effects(endotracheal intubation rate,mortality rate and complication rate within 24 h)of the two groups were compared,and the correlation between the time from admission to NIPPV in the prone position and the total time of NIPPV was analyzed.Results In group A,HR,MAP,respiratory rate and PaCO2 all showed a decreasing trend,while PaO2,SpO2 and oxygenation index all showed an increasing trend,showing significant differences(P＜0.05,P＜0.01).There was no significant difference in pH value between the two groups at 0 h,12 h,and 24 h after admission(P＞0.05).The rate of endo-tracheal intubation,mortality and complications within 24 h after admission in group A were lower than those in group B(P＜0.05).The time from admission to NIPPV in the prone position was significantly correlated with the total duration of NIPPV(r=0.34,P＜0.01).Conclusion Early application of NIPPV in the prone position in patients with ARF can significantly improve hemodynamics,respiratory function,oxygenation and other related indexes,and the therapeutic effect is obvious.
关键词
呼吸功能不全/俯卧位/无创正压通气/血流动力学/动脉血氧分压/血氧饱和度/氧合指数
Key words
Respiratory insufficiency/Prone position/Non-invasive positive pressure ventilation/Hemodynamics/Arterial partial pressure of oxygen/Blood oxygen saturation/Oxygenation index
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