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目的研究应用双水平气道正压通气(BiPAP)治疗重症肌无力所致急性呼吸衰竭的治疗作用。方法回顾性分析2011-2013年收治的重症肌无力合并急性呼吸衰竭患者而使用双水平气道正压通气(BiPAP)治疗23例,比较他们BiPAP治疗前、治疗后2 h的动脉血气分析数据的变化,心率、呼吸频率及治疗2周后症状改善情况(QMG评分),并进行统计学分析。结果 23例患者中有18例无创机械通气治疗前患者心率(HR),呼吸频率(RR),血浆pH值,动脉血氧分压(PaO_2),动脉血二氧化碳分压(PaCO_2)分别为(108.7±17.6)次/min,(25.8±5.3)次/min,7.31±0.04,(58.7±13.3)mmHg,(53.8±7.8)mmHg;治疗后2小时患者HR、RR、血浆pH值PaO_2、PaCO_2分别为(83.4±15.9)次/min,(21.1±4.9)次/min,7.36±0.04,(83.4±15.7)mmHg,(38.6±7.0)mmHg,较治疗前均明显改善。(P<0.05),治疗前患者QMG评分为17.94±2.07分,治疗2周后患者QMG评分为(10.06±2.71)分,也较治疗前有显著改善。(P<0.01)。结论 BiPAP治疗对重症肌无力所致急性呼吸衰竭的有重要治疗价值,能有效改善患者的呼吸功能。
Objective To study the therapeutic effect of bi-level positive airway pressure (BiPAP) in the treatment of acute respiratory failure caused by myasthenia gravis. Methods A retrospective analysis of 23 patients with myasthenia gravis combined with acute respiratory failure treated with bi-level positive airway pressure (BiPAP) from 2011 to 2013 was performed. The arterial blood gas analysis data before and after treatment with BiPAP Changes, heart rate, respiratory rate, and symptom improvement after 2 weeks of treatment (QMG score), and statistical analysis. Results Among the 23 patients, the HR, respiratory rate, plasma pH, PaO_2 and PaCO_2 of 18 patients before non-invasive mechanical ventilation were 108.7 ± 17.6) times / min, (25.8 ± 5.3) times / min, 7.31 ± 0.04, (58.7 ± 13.3) mmHg, (53.8 ± 7.8) mmHg; HR, RR, PaO_2 and PaCO_2 (83.4 ± 15.9) times / min, (21.1 ± 4.9) times / min, 7.36 ± 0.04, (83.4 ± 15.7) mmHg, (38.6 ± 7.0) mmHg, compared with before treatment were significantly improved. (P <0.05). The QMG score of patients before treatment was 17.94 ± 2.07 points, and the QMG score was (10.06 ± 2.71) points after 2 weeks of treatment, which was also significantly improved compared with that before treatment. (P <0.01). Conclusion BiPAP treatment has important therapeutic value on acute respiratory failure caused by myasthenia gravis and can effectively improve the respiratory function of patients.