| 摘要: |
| 目的探讨早期间断性无创正压通气（NPPV）治疗艾滋病（AIDS）合并肺孢子菌病（PCP）致低氧血症的疗效。方法选择诊断为AIDS合并PCP致低氧血症的患者48例，均采用抗PCP治疗，在通畅呼吸道、适当氧疗、控制各种感染、营养对症支持治疗及应用糖皮质激素等治疗基础上，采用NPPV治疗，分为早期间断性NPPV组（研究组）和晚期间断性NPPV组（对照组），比较两组患者气管插管率及病死率，行NPPV前后的生命体征指标及血气分析指标等。结果观察组患者的总治疗时间及每天治疗时间均较对照组明显减少，改有创通气比例及病死率均降低，两组比较差异均有统计学意义（均P＜0.01）；NPPV短时间能明显改善患者的缺氧状态，两组患者呼吸频率、心率、体温明显下降，PaO2、二氧化碳分压（PaCO2）、血氧饱和度（SaO2）明显提高，pH值明显降低，差异均有统计学意义（均P＜0.01）。结论早期间断性NPPV治疗HIV合并PCP的疗效明显，值得临床应用。 |
| 关键词: 艾滋病 肺孢子菌病 无创正压通气 低氧血症 |
| DOI：10.12056/j.issn.1006-2785.2017.40.3.2016-1630 |
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| Earlier intermittent noninvasive positive pressure ventilation in treatment of hypoxemia in AIDS patients with pneumocystis pneumonia |
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Hangzhou Xici hospital
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| Abstract: |
| Objective To evaluate the clinical effect of earlier intermittent noninvasive positive pressure ventilation
(EINPPV) in treatment of hypoxemia in AIDS patients with Pneumocystis carinii pneumonia(PCP). Methods Forty eight AIDS- related PCP patients with hypoxemia, admitted in ICU from January 2013 to January 2016, were treated with EINPPV(study group) or later intermittent noninvasive positive pressure ventilation (LINPPV, control group), respectively. All patients were treated with antiPCP therapy, ventilation was adopted on the basis of patency of respiratory tract, appropriate oxygen therapy, infections control, supportive nutritional therapy and administration of glucocorticoids. The vital signs and blood gas analysis were documented, the endotracheal intubation rate and mortality were compared between two groups. Results The symptoms of patients were significantly improved, and the blood gas analysis showed that PaO2, PCO2, SaO2 were increased, and pH
decreased after NPPV in both groups (P＜0.05). Compared to control group, the total ventilation time and daily ventilation time of
study group were significantly lower, and endotracheal intubation rate and in hospital mortality were significantly decreased (all
P＜0.01). Conclusion EINPPV is superior to LINPPV in the treatment of hypoxemia for AIDS-related PCP patients. |
| Key words: AIDS PCP NPPV Hypoxemia |
