【摘要】 目的 :评价机械通气早期拔管改换无创机械通气治疗急性有机磷农药中毒 (AOPP)中间综合征 (IMS)的治疗效果。方法 :选择接受气管插管和机械通气的AOPPIMS 10例 ,以同步间歇强制通气 +压力支持通气 (SIMV +PSV )方式行机械通气 ,待IMS控制时 ,改用经鼻面罩压力支持通气 +呼吸未正压 (PSV +PEEP)方式 (序贯治疗组 ) ;另对病情具有可比性的 10例患者按常规行有创继续机械通气治疗 (对照组 )。结果 :序贯治疗组的有创机械通气时间、总机械通气时间和住ICU时间均较对照组明显缩短 [( 8.0± 4.3 )vs( 2 2 .3± 1.5 )d ;( 12 .6± 6.1)vs( 2 2 .1± 1.5 )d ;( 14± 8)vs( 2 7± 13 )d ;P <0 .0 5 ] ;序贯治疗组中发生呼吸机相关性肺炎的例数较对照组显著减少 ( 1vs 7,P <0 .0 5 )。结论 :对AOPPIMS机械通气病例 ,以中间综合征控制窗为时机早期拔管 ,改用经鼻面罩无创通气可以显著提高治疗效果更多还原

【Abstract】 Objective:To evaluate the therapeutic efficacy of early extubation and subsequent non invasive mechanical ventilation(MV) in intermediate syndrome(IMS) due to acute organophosphate poisoning(AOPP).Methods:Twenty patients with IMS were randomly allocated to 2 groups:treatment group accepted invasive MV and subsequent non invasive MV,whereas control group were treated with continuous invasive MV.Results:Compared with control group,the duration of invasive MV,total duration of ventilatory assistance,hospitalized time in ICU and incidence of ventilator associated pneumonia were significantly decreased in treatment graup( P< 0.05).Conclusion:Early extubation followed by non invasive MV could be an effective method in the treatment of IMS caused by AOPP. [更多还原