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[目的]探讨双水平气道正压通气(BiPAP)在肥胖病人围术期的应用。[方法]将48例择期全身麻醉插管手术的肥胖病人随机分为观察组及对照组备24例,对照组采用常规围术期护理,必要时给予鼻导管或面罩给氧,观察组在常规围术期护理基础上术前3d~7 d及术后拔除气管插管后使用BiPAP进行无创呼吸支持。比较两组病人治疗前、术后24 h心率、呼吸频率、血气分析pH、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、血氧饱和度(SaO_2)]变化情况以及术后气管插管脱管时间、氧疗时间、术后下床活动时间。[结果]观察组病人术后24 h心率、呼吸频率、PaCO_2水平低于对照组,pH、PaO_2、SaO_2水平高于对照组,术后气管插管脱管时间、氧疗时间、术后下床活动时间短于对照组(P<0.05);观察组24例使用BiPAP治疗的病人均无呼吸机相关并发症发生。[结论]肥胖病人在围术期预防性应用BiPAP,可以改善其肺功能,减少并发症,促进康复。
[Objective] To investigate the application of bi-level positive airway pressure (BiPAP) in the perioperative period of obese patients. [Methods] Forty-eight obese patients undergoing elective general anesthesia intubation were randomly divided into observation group (24 cases) and control group (24 cases). The control group received routine perioperative nursing, nasal catheter or mask was given oxygen if necessary, Perioperative nursing based on preoperative 3d ~ 7 d and after removal of tracheal intubation using BiPAP for noninvasive respiratory support. The changes of heart rate, respiratory rate, blood gas analysis, PaO_2, PaCO_2 and SaO_2 before and 24 h after operation were compared between the two groups After the endotracheal tube detachment time, oxygen therapy time, ambulation time after surgery. [Results] The heart rate, respiratory rate, PaCO_2 level in patients in observation group were significantly lower than those in control group, pH, PaO_2 and SaO_2 levels were significantly higher than those in control group at 24 hours after operation. The postoperative tracheal intubation time, oxygen therapy time, The duration of activity was shorter than that of the control group (P <0.05). No ventilator-related complications occurred in 24 patients treated with BiPAP in the observation group. [Conclusion] The prophylactic use of BiPAP in obese patients during perioperative period can improve lung function, reduce complications and promote rehabilitation.