【摘要】 目的观察早期采用无创正压通气(NIPPV)治疗重症社区获得性肺炎(CAP)合并呼吸衰竭的疗效。方法将社区获得性重症肺炎合并呼吸衰竭患者分为早期采用无创正压通气组(治疗组)及拒绝无创正压通气组(对照组),比较两组患者治疗前后呼吸频率、血气分析变化,比较两组患者气管插管率、病死率、RICU住院天数。结果治疗组患者治疗2小时后PaO2较治疗前升高,差异有显著性;治疗组患者24小时后的呼吸频率、PaCO2较治疗前降低,pH、PaO2较治疗前升高,差异有显著性;治疗组2小时后、24小时后PaO2较对照组同时间PaO2高,差异有显著性。治疗组气管插管率、病死率、RICU住院天数低于对照组,差异有显著性。结论早期应用无创正压通气是治疗社区获得性重症肺炎合并呼吸衰竭的有效手段,可显著改善患者的预后,降低病死率,值得推广。更多还原

【Abstract】 Objective To study the efficacy of early noninvasive positive airway pressure ventilation(NIPPV) in severe community-acquired pneumonia(CAP) with respiratory failure.Methods Patients were divided into the study group and the control group.The patients received NIPPV based on conventional treatment as the study group,the other patients treated with only conventional treatment as control group.Respiratory rate,arterial blood gases change,intubation rate,moratlity rate and RICU stay were compared in two groups.Results The PaO2 in 2 hours after treatment of study group were higher than that in control group.The respiratory rate and PaCO2 in 24 hours after treatment of study group were lower than that in control group,the pH and PaCO2 in 24 hours after treatment were lower than that in control group.The intubation rate,moratlity rate and RICU stay of study group were lower than that in control group.Conclusion Early NIPPV is effective therapy in severe CAP with respiratory failure.It can improve hypoxia,decrease intubation rate,mortality rate and RICU stay.更多还原