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目的探讨无创正压通气(NIPPV)治疗闭合性胸外伤致呼吸衰竭的临床疗效。方法 23例患者均有呼吸窘迫症状,在综合治疗基础上,给予无创正压通气治疗,选择S模式,吸气气道正压(IPAP)12～18 cm H2O,呼气气道正压(EPAP)4～8 cm H2O,通气时间日平均在16 h以上,吸氧浓度0.3～0.4,做好气道湿化和护理,最终观察其临床疗效。结果 23例患者经无创正压通气治疗后21例有效(有效率为91.3%),无效2例。21例治疗有效患者的动脉血氧分压明显增高,呼吸频率明显下降,治疗前后比较用配对t检验,差异有统计学意义(P<0.01)。结论无创正压通气应用于闭合性胸外伤所致的呼吸衰竭,能明显改善患者的低氧血症,有效地缓解呼吸窘迫症状,临床疗效良好,还能较大程度地避免由于引流不畅所致的肺部感染或感染加重,从而提高救治成功率。
Objective To investigate the clinical effect of noninvasive positive pressure ventilation (NIPPV) on respiratory failure caused by closed chest trauma. Methods Twenty-three patients had respiratory distress symptoms. On the basis of comprehensive treatment, noninvasive positive pressure ventilation was used. S mode, IPAP 12 ~ 18 cm H2O, EPAP ) 4 ~ 8 cm H2O, mean daily ventilation time was above 16 h, oxygen concentration 0.3 ~ 0.4, airway wetting and nursing, the final observation of its clinical efficacy. Results Twenty-three patients were effective after non-invasive positive pressure ventilation (effective rate was 91.3%) and 2 were ineffective. The arterial partial pressure of oxygen of 21 patients who were treated effectively increased significantly and the respiratory rate decreased obviously. The paired t test was used before and after treatment, the difference was statistically significant (P <0.01). Conclusion Non-invasive positive pressure ventilation applied to respiratory failure caused by closed chest trauma can significantly improve patients with hypoxemia, effectively alleviate the symptoms of respiratory distress, clinical efficacy is good, but also to a greater extent avoid due to poor drainage Caused by increased lung infection or infection, thereby improving the success rate of treatment.