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目的急诊危重监护室呼吸机对急性脑出血合并呼吸衰竭患儿的临床价值分析。方法选取我院收治的96例急性脑出血合并呼吸衰竭患儿,根据患者最后是否死亡,分成成功组和病死组。成功组36例,病死组60例。均经口气管插管连接呼吸机辅助呼吸。通气模式:CAV+PEEP、同步间断压迫性通气(SIMV)+呼气末正压(PEEP)。PEEP值:510cmH2O(1cmH2O=0.098kPa)。其余按急性脑出血常规治疗:对症治疗、营养液细胞、降低颅内压、脱水治疗。并观察两组平均动脉压、APACHEⅡ评分值,动脉血气变化。结果成功组和病死组通气前后的平均动脉压、APACHEⅡ评分值、动脉血气相互比较差异有统计学意义(P<0.05)。成功组与病死组患者通气前、通气后指标分别相互比较差异有统计学意义(P<0.05)。结论急诊危重监护室呼吸机对急性脑出血合并呼吸衰竭患儿具有一定的作用,且患者通气前平均动脉压、APACHEⅡ评分、动脉血气明显影响患者的成功率。但对于急性脑出血合并呼吸衰竭抢救时,应综合考虑,选择最佳的治疗方案。
Objective To analyze the clinical value of emergency ventilator in critically ill intensive care unit in children with acute cerebral hemorrhage complicated with respiratory failure. Methods Ninety-six children with acute cerebral hemorrhage complicated with respiratory failure admitted to our hospital were divided into two groups: successful group and dead group according to whether they died or not. 36 cases were successful, 60 cases died. All through the endotracheal tube connected to ventilator-assisted breathing. Ventilation mode: CAV + PEEP, Simultaneous Disrupted Compressed Ventilation (SIMV) + Positive End Expiratory Pressure (PEEP). PEEP value: 510 cm H2O (1 cm H2O = 0.098 kPa). The rest by conventional treatment of acute cerebral hemorrhage: symptomatic treatment, nutrient fluid cells, reduce intracranial pressure, dehydration treatment. The mean arterial pressure, APACHEⅡscore and arterial blood gas changes were observed. Results Before and after ventilation, the mean arterial pressure, APACHEⅡscore and arterial blood gas between the successful group and the dead group were significantly different (P <0.05). The difference between the two groups was statistically significant (P <0.05). Conclusions The ventilator in emergency critical care unit may play a certain role in the patients with acute cerebral hemorrhage complicated with respiratory failure. The mean arterial pressure, APACHEⅡscore and arterial blood gas of patients before and after ventilation significantly affect the success rate of patients. However, for acute cerebral hemorrhage and respiratory failure rescue, should be considered, choose the best treatment.