序贯机械通气在慢性阻塞性肺疾病并呼吸衰竭中的应用  

Sequential mechanical ventilation in chronic obstructive pulmonary disease with concomitant respiratory failure

作　　者：林卫涵[1] 吴卫锋[1] 陈颖丰[1] 罗书裕[1] 

机构地区：[1]广东省揭阳市人民医院呼吸内科,广东揭阳522000

出　　处：《广州医学院学报》2013年第2期64-66,共3页Academic Journal of Guangzhou Medical College

摘　　要：目的:探讨序贯机械通气在慢性阻塞性肺疾病(COPD)合并呼吸衰竭中的应用价值。方法:收集2011年4月至2013年2月广东省揭阳市人民医院收治的40例COPD合并呼吸衰竭的患者作为研究对象,随机分为序贯组(序贯机械通气)和传统组(有创机械通气),每组20例。比较两组生命体征、血气分析、呼吸机参数、呼吸机相关性肺炎发生率、死亡率、有创机械通气时间、住ICU时间、住院费用等指标。结果:两组患者生命体征、血气分析、呼吸机参数比较,差异无统计学意义(P>0.05)。序贯组有创机械通气时间、ICU入住时间、住院费用、呼吸机相关性肺炎发生率、死亡率均少于传统组(P<0.05)。结论:对于COPD合并严重呼吸衰竭,序贯机械通气可降低呼吸机相关性肺炎发生率和死亡率下降,缩短有创机械通气时间、ICU入住时间,减少住院费用,是较好的机械通气策略。Objective：To investigate the value of sequential mechanical ventilation in patients with chronic obstructive pulmonary disease （COPD） and concomitant respiratory failure. Methods： A total of 40 patients with COPD and concomitant respiratory failure admitted to Guangdong Jieyang People＇ s Hospital between April 2011 and February 2013 were randomly assigned to receive sequential mechanical ventilation （sequential ventilation group, n = 20） or invasive mechanical ventilation （conventional ventilation group, n = 20）. The vital signs, blood-gas analysis indices, parameters of respirator, incidence of respirator-associated pneumonia, mortality, duration of invasive mechanical ventilation, length of ICU stay and cost of hospital stay were compared. Results： The difference in vital signs, blood-gas analysis indices and parameters of respirator was unremarkable （ all P 〉 0.05）. Sequential ventilation group was associated with reduced incidence of respirator-associated pneumonia, mortality, duration of invasive mechanical ventilation, length of ICU stay and cost of hospital stay （all P 〈 0. 05 ）. Conclusion ： Sequential mechanical ventilation is a preferable strategy for mechanical ventilation owing to a lower incidence of respirator-associated pneumonia and mortality as well as reduced duration of invasive mechanical ventilation, length of ICU stay and cost of hospital stay in patients with COPD and concomitant respiratory failure.

关 键 词：序贯机械通气 慢性阻塞性肺疾病 呼吸衰竭 

分 类 号：R563.19[医药卫生—呼吸系统]