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目的 探讨鼻罩持续气道正压通气(n-CPAP)治疗严重急性呼吸综合征(SARS)的疗效。方法 37例重症SARS患者经高流量吸氧治疗后缺氧及呼吸窘迫等症状元改善,采用n-CPAP治疗。CPAP水平为4～8 cmH_2O。结果 治愈25例(成功组),通气前呼吸频率(RR)为(31.8±4.6)次/min,SpO_2为(91.6±1.7)％;平均通气时间为(12.7±5.6)d。转为有创通气12例(失败组),通气前呼吸频率(RR)为(45.8±8.7)次/min,SpO_2为(86.2±4.3)％;平均通气时间为(2.99±2.6)d。治疗1h后,成功组RR下降到(25.8±4.2)次/min(P0.05),SpO_2上升到(97.0±1.7)％(P<0.05)。结论 对重症传染性非典型肺炎患者,CPAP治疗有利于改善肺的氧合功能,减轻呼吸困难,成功率达到67.6％。CPAP是治疗重症传染性非典型肺炎的较好方法之一。
Objective To investigate the efficacy of nasal continuous positive airway pressure (n-CPAP) in the treatment of severe acute respiratory syndrome (SARS). Methods Thirty-seven patients with severe SARS were treated with n-CPAP after hypoxia and respiratory distress after high-flow oxygen therapy. CPAP level of 4 ~ 8 cmH_2O. Results The results showed that the respiratory rate (RR) was (31.8 ± 4.6) times / min before ventilation, and (91.6 ± 1.7)% for SpO2. The mean duration of ventilation was (12.7 ± 5.6) days. The ventilatory respiratory rate (RR) was (45.8 ± 8.7) / min and SpO_2 was (86.2 ± 4.3)%, mean ventilation time was (2.99 ± 2.6) days in 12 patients who had invasive ventilation. After 1 hour of treatment, the RR of RRT decreased to (25.8 ± 4.2) / min (P <0.05) and that of SpO2 increased to (97.0 ± 1.7)% (P <0.05) in the successful group. The failure RR decreased to (40.7 ± 11.2) times / min (P> 0.05), and that of SpO2 increased to (97.0 ± 1.7)% (P <0.05). Conclusion For patients with SARS, CPAP treatment is helpful to improve lung oxygenation function and alleviate dyspnea with a success rate of 67.6%. CPAP is one of the better ways to treat SARS.