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目的探讨无创正压通气对急性呼吸窘迫综合征肺复张的治疗作用。方法ARDS患者20例,所有的患者均给予NIPPV治疗,同时给予积极的病因治疗及其他综合治疗。于NIPPV前、治疗后15min、1h、2h、4h经桡动脉抽动脉血监测PH、PaO2、PaCO2、PaO2/FiO2。记录NIPPV前,NIPPV后30s记为0min、NIPPV后2、5、15、30minSpO2、HR、平均动脉压(MAP)和CVP变化。结果NIPPV前后各时间点MAP及HR没有显著性变化,NIPPV后CVP较肺复张前增加但没有统计学意义,NIPPV治疗后SpO2各时间点与治疗前比较有统计学意义(P<0.05)与。NIPPV治疗前后的pH、PaCO2没有明显变化,治疗后15min、1h、2h的PaO2及PaO2/FiO2与治疗前比较统计学意义(P<0.01)。结论NIPPV对病情相对较轻的ARDS患者是有效的支持治疗手段,在早期可选用NIPPV治疗是安全、有效的。
Objective To investigate the therapeutic effect of noninvasive positive pressure ventilation on pulmonary recurrent respiratory distress syndrome. METHODS: Twenty patients with ARDS were enrolled in this study. All patients were treated with NIPPV, and positive etiological therapy and other comprehensive treatment were given. Before NIPPV, PH, PaO2, PaCO2, PaO2 / FiO2 were monitored by radial artery pulse at 15 min, 1 h, 2 h and 4 h after treatment. Before NIPPV recording, NIPPV was recorded as 0min after 30s, changes of SpO2, HR, mean arterial pressure (MAP) and CVP at 2,5,15,30min after NIPPV. Results There was no significant change in MAP and HR at various time points before and after NIPPV. CVP after NIPPV was higher than that before lung recruitment but not statistically significant. SpO2 at various time points after NIPPV treatment were significantly different from those before treatment (P <0.05) . There was no significant change in PaCO2 before and after NIPPV treatment. PaO2 and PaO2 / FiO2 at 15 min, 1 h and 2 h after treatment were statistically significant (P <0.01). Conclusion NIPPV is an effective supportive treatment for patients with ARDS in relatively mild condition. NIPPV can be used safely and effectively in the early stage.