论文部分内容阅读
目的观察双水平无创正压通气技术(BiPAP)治疗急性大面积脑梗死合并呼吸衰竭的疗效及其影响因素。方法选取大面积脑梗死合并呼吸衰竭患者64例,按照预后分为生存组和死亡组,并检测各组的氧分压(PO2)、二氧化碳分压(PCO2)、pH值、氧合指数(OI)、前白蛋白(PA)和高敏C反应蛋白(hs-CRP)的影响。结果 64例大面积脑梗死合并呼吸衰竭患者的生存率为60.94%(39/64)。通气后两组的pH值、PCO2、PO2、OI和PA均较通气前明显提高(P<0.01),且生存组的PCO2、PO2、OI和PA水平较死亡组升高更为明显(P<0.01),而pH值两组无明显变化(P>0.05);两组的hs-CRP水平均较治疗前明显降低(P<0.01),且生存组的hs-CRP水平较死亡组降低更为明显(P<0.01)。结论 BiPAP呼吸机在治疗急性大面积脑梗死合并呼吸衰竭的疗效显著,通气前动脉血气、OI、PA和hs-CRP水平对患者的预后有明显的影响。
Objective To observe the efficacy and influencing factors of bi-level noninvasive positive pressure ventilation (BiPAP) in the treatment of acute large area cerebral infarction with respiratory failure. Methods Sixty-four patients with large cerebral infarction and respiratory failure were selected and divided into survival group and death group according to the prognosis. The changes of PO2, PCO2, pH, oxygenation index (OI) ), Prealbumin (PA) and high-sensitivity C-reactive protein (hs-CRP). Results The survival rate of 64 patients with large area cerebral infarction and respiratory failure was 60.94% (39/64). The values of PCO2, PO2, OI and PA in the two groups after ventilation were significantly higher than those before ventilation (P <0.01), and the levels of PCO2, PO2, OI and PA in the survival group were higher than those in the death group (P < 0.01), while there was no significant difference between the two groups (P> 0.05). The levels of hs-CRP in both groups were significantly lower than those before treatment (P <0.01), and the levels of hs-CRP Obviously (P <0.01). Conclusions BiPAP ventilator is effective in treating acute large-area cerebral infarction with respiratory failure. Arterial blood gas, OI, PA and hs-CRP level before ventilatory have a significant effect on the prognosis of patients.