序贯机械通气联合参麦注射液治疗COPD重症呼吸衰竭临床研究  

Clinical study of sequential mechanical ventilation combined with Shenmai Injection in COPD patients with severe respiratory failure

作　　者：张菊香[1] 李素引[1] 

机构地区：[1]河北医科大学附属衡水哈励逊国际和平医院呼吸科,河北衡水053000

出　　处：《临床肺科杂志》2011年第8期1179-1181,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨有创与无创序贯性机械通气联合参麦注射液在COPD重症呼吸衰竭中疗效。方法对105例COPD重症呼吸衰竭患者随机分为三组:A组肺部感染控制窗出现后,继续按常规有创机械通气方法治疗,以目前临床常用脱机模式压力支持(PS)模式脱机。B组即序贯组出窗后立即拔出气管插管,改用口鼻面罩双水平气道正压通气(B iPAP)。C组B组加用中药参麦注射液对COPD进行干预,参麦注射液40 m l加入5%葡萄糖250 m l静滴,每日1次,共10 d。比较三组总机械通气时间、VAP例数、住院时间。所得数据应用SPSS10.0统计分析。结果三组患者发生VAP的例数分别为16、8和5(P<0.05),总机械通气时间为(441±36)、(292±29)和(245±26)h(P<0.05);住院时间为(633±83)、(391±43)和(369±41)h(P<0.05)。结论在肺部感染控制窗指导下的序贯性机械通气联合参麦注射液治疗COPD重症呼吸衰竭,可以明显缩短机械通气时间,降低VAP发病率,缩短总住院时间,改进治疗效果,是具有临床实用价值的有效脱机方案。Objective To research the method and effect of sequential non-invasive following short-term invasive mechanical ventilation combined with Shenmai Injection in COPD patients with severe respiratory failure.Methods 105 COPD patients with severe respiratory failure were randomly divided into three groups.When pulmonary infection had been controlled,the patients in Group A（n=35） were kept treating by invasive mechanical ventilation and weaned by PSV mode.The patients in Group B（n=35） were extubated and treated by non-invasive mechanical ventilation via facial mask with bi-level positive airway pressure（BiPAP）.The patients in Group C（n=35） received the same treatment as Group B with an exception of the addition use of intravenous infusion of SMI 40 ml once a day,for 10 days.Measures of the duration of total mechanical ventilation,the length of hospital stay,and the incidence of ventilation associated with pneumonia（VAP） were recorded.Results For the three groups of A,B,and C,the incidences of VAP were 16,8,and 5,respectively（P0.05）;the durations of the total mechanical ventilation were 441±,292（±29） and 245（±26）,respectively（P0.058）;the length of hospital stay were 633（±83）,391（±43） and369（±41）,respectively（P0.05）.Conclusion Sequential non-invasive following invasive mechanical ventilation at the time of PIC window combined with Shenmai Injection is valuable and effective in terms of decreasing the duration of mechanical ventilation and length of hospital stay and reducing the incidence of VAP.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 序贯机械通气 参麦注射液 

分 类 号：R563.9[医药卫生—呼吸系统]