间断直接脱机与加热湿化给氧法对慢性阻塞性肺疾病患者脱机时间的影响  

The effect of intermittent off ventilation,heating and humidification oxygen on timing of off ventilation among patients with COPD

作　　者：黄敏容[1] 

机构地区：[1]广西医科大学第四附属医院ICU,柳州545005

出　　处：《内科》2007年第6期889-891,共3页Internal Medicine

摘　　要：目的比较不同的脱机与护理方法对慢性阻塞性肺疾病(COPD)机械通气患者脱机时间的影响,为COPD机械通气患者寻找一种有效的脱机与护理方法。方法对符合临床脱机的103例COPD机械通气患者随机分为3组,Ⅰ组采用SIMV+PSV通气法,逐步降低通气条件后至完全脱机;Ⅱ组采用间断直接脱机法进行脱机锻炼,脱机期间以持续气道湿化法进行人工气道护理、给氧等,Ⅲ组采用间断直接脱机法进行脱机锻炼,脱机期间使用加热湿化器进行气道加温湿化、给氧护理。比较3组间的脱机时间、48h后脱机失败发生率,以及Ⅱ组与Ⅲ组在脱机锻炼过程中的不同湿化效果和氧合状态。结果3个组脱机时间分别为Ⅰ组(120±43.2)h,Ⅱ组(86±12.6)h,Ⅲ组(50±21.2)h,Ⅲ组的脱机时间明显短于Ⅰ组和Ⅱ组,差异有统计学意义(P<0.05),Ⅱ组的脱机时间短于Ⅰ组(P<0.05),Ⅲ组湿化、氧合效果优于Ⅱ组,差异有统计学意义。结论COPD机械通气患者在脱机过程中采用间断直接脱机法进行脱机锻炼,脱机期间使用加热湿化器进行气道加温湿化、给氧护理,能明显缩短脱机时间,提高脱机的成功率。Objective To compare the effects of different methods of withdrawal from ventilatory support and nursing on timing of off ventilation ,and in turn find out effective off ventilation and nursing methods for patients with chronic obstructive pulmonary diseases （COPD）. Methods 103 COPD patients on ventilators were randomized into three groups. In groupl, SIMV ＋ PSV 予 was used and the index of ventilation were gradually reduced. In group2,intermittent off ventilation and continuous humidification oxygen through the airway were applied manually. In groupl ,intermittent off ventilation and continuous heating and humidification oxygen through the airway were applied with humidifier. The off ventilation time, failure rate of off ventilation after 48 hours in the three groups and humidification and oxygenation effects during intermittent off ventilation in group land group 2 were compared. Result The time for off ventilation were at （120±43.2）hs,（86±12,6）hs,（50±21.2）hs respectively in the three groups. Ventilation time in group 3 was significantly shorter than the other two groups （ P 〈 0.05 ）. The ventilation time in group 2 was shorter than that in group 1. The effects of humidification and oxygenation in group 3 were better than those in group 2. All differences were of statistical significance. Conclusion Intermittent off ventilation and continuous heating and humidification oxygen through the airway with humidifier can shorten ventilation time and improve off ventilation success rate,

关 键 词：慢性阻塞性肺疾病 脱机 加温 湿化 给氧 

分 类 号：R473.5[医药卫生—护理学]