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目的观察面罩通气治疗肝性脑病的疗效。方法回顾性分析2011年1月—2014年12月在徐州市中心医院治疗的60例肝性脑病患者的临床资料,其中28例为鼻导管吸氧,32例给予面罩通气,比较二组患者治疗前后血氨水平、动脉血二氧化碳分压(PaCO2)。结果二组患者的年龄、性别、肝功能分级和肝硬化病因差异均无统计学意义(P>0.05)。治疗前鼻导管给氧组肝性脑病平均分级为2.86±0.87,面罩通气组平均分级为3.13±0.72,二组比较差异无统计学意义(t=0.927,P=0.362)。经过48h治疗后,面罩通气组治疗后肝性脑病分级显著低于鼻导管给氧组,1.69±0.60vs.2.43±1.02,二组比较差异有统计学意义(t=2.386,P=0.027);面罩通气组血氨下降程度显著高于鼻导管给氧组(t=-3.385,P=0.002);面罩通气组PaCO2水平显著高于鼻导管给氧组,38.7±5.0vs.27.6±6.3,(t=-5.363,P<0.001)。结论面罩通气能够纠正肝性脑病患者的低二氧化碳血症,从而有助于肝性脑病的治疗。
Objective To observe the curative effect of mask ventilation on hepatic encephalopathy. Methods The clinical data of 60 patients with hepatic encephalopathy treated in Xuzhou Central Hospital from January 2011 to December 2014 were retrospectively analyzed. Among them, 28 patients received nasal oxygenation and 32 patients received mask ventilation. The patients in the two groups were compared Blood ammonia level before and after arterial carbon dioxide partial pressure (PaCO2). Results There was no significant difference in the age, sex, grade of liver function and cause of cirrhosis between the two groups (P> 0.05). Before treatment, the mean grade of hepatic encephalopathy in nasal catheterization group was 2.86 ± 0.87, and the average score in mask ventilation group was 3.13 ± 0.72. There was no significant difference between the two groups (t = 0.927, P = 0.362). After 48h treatment, the grade of hepatic encephalopathy in mask ventilation group was significantly lower than that in nasal catheterization group (1.69 ± 0.60vs.2.43 ± 1.02, t = 2.386, P = 0.027). The level of PaCO2 in the mask ventilation group was significantly higher than that in the nasal catheter ventilation group (38.7 ± 5.0 vs 27.6 ± 6.3, t = -3.385, P = 0.002) t = -5.363, P <0.001). Conclusions Mask ventilation can correct hypoglycemia in patients with hepatic encephalopathy and thus contribute to the treatment of hepatic encephalopathy.