无创通气在AECOPD机械通气患者撤机中的研究  

Randomized Prospective Study of Noninvasive Ventilation in Weaning of Hyperapneic Respiratory Failure Due to AECOPD

作　　者：黄乐为[1] 王东亮[1] 侯丽丽[1] 孙子淞 

机构地区：[1]解放军第202医院呼吸科,辽宁沈阳110000

出　　处：《现代生物医学进展》2013年第29期5743-5745,共3页Progress in Modern Biomedicine

摘　　要：目的:通过前瞻性随机对照研究比较应用NIPPV与PSV两种撤机方法在治疗AECOPD合并Ⅱ型呼吸衰竭进行机械通气撤机困难患者中的优越性。方法:达到撤机标准但经两小时自主呼吸试验(SBT)失败的患者被分为两组:PSV组和无创通气组。观测有创通气时间、机械通气总时间、再插管率、住呼吸重症监护室时间和VAP发生率等指标。结果:NIPPV组较PSV组气管插管时间显著缩短,VAP发生率、再插管率及住院费用均较PSV通气组显著降低。结论:采用无创通气撤机法治疗AECOPD合并Ⅱ型呼吸衰竭较传统的机械通气方式在有效缩短有创通气时间,降低VAP发生率,改善患者预后方面更优越。Objective： To study the effects of non Invasive positive pressure ventilation （NIPPV） and pressure support ventilation （PSV） in the weaning process for patients with acute exacerbation chronic obstructive pulmonary disease （AECOPD） and hypercapnic respiratory failure. Methods：30 hypercapnic respiratory failure AECOPD patients requiring mechanical ventilation in respiratory intensive care unit （RICU） were enrolled after SBT faliure. The patients were randomly divided into two groups, PSV group and NIPPV group. The changes of blood gas before and after the weaning and the ratio of weaning failure, weaning succeed and reintubation were observed. And then, the effects and clinical utility of these two methods were compared. Results： Compared to PSV group, NIPPV showed a trend in reducing mortality, extubation and high ratio of weaning, and can be applied widely in clinical. Conclusion： It is suggested that the ap- plication of noninvasive ventilation type ventilator on the trealment of AECOPD combined with the type II respiratory failure should be well promoted with the advantages of reducing the incidence Of VAP and improving the prognosis of patients when comparing with the conventional one.

关 键 词：慢性阻塞性肺疾病急性加重(AECOPD) 无创正压通气(NIPPV) 撤机 

分 类 号：R563[医药卫生—呼吸系统]