保护性机械通气治疗老年COPD伴肺大泡合并Ⅱ型呼吸衰竭的临床观察  

Clinical observation of protective mechanical ventilation treatment elderly patients with COPD with pulmonary bulla with type II respiratory failure

作　　者：王红鸾[1] 蔡金莲[1] 付强[1] 喻杰[1] 

机构地区：[1]江西省人民医院呼吸二科,南昌330006

出　　处：《江西医药》2014年第3期189-191,共3页Jiangxi Medical Journal

基　　金：江西省卫生厅基金资助项目(20061504)

摘　　要：目的比较传统机械通气和肺保护性机械通气治疗老年COPD伴肺大泡合并II型呼吸衰竭的临床疗效。方法选择42例老年COPD伴肺大泡合并II型呼吸衰竭的患者给予综合治疗并随机均分为两组,A组采用保护性机械通气,B组采用传统的机械通气方法。比较两组患者机械通气期前后动脉血pH、PaO2、PaCO2、SaO2等及机械通气所致的并发症。结果 A组无患者死亡,B组1例死亡,两组生存活率方面差异无统计学意义(P>0.05);A组与B组机械通气时间分别为7.6d和9.8d,两组比较差异有统计学意义(P<0.05),转为有创通气分别为2/21和6/21,两组比较差异有统计学意义(P<0.05)。住院时间分别为15.6d和22.8d,两组比较差异有统计学意义(P<0.05)。结论对于肺大泡合并II型呼吸衰竭患者,采取保护性机械通气,可以减少机械通气所致并发症发生率,缩短机械通气时间和住院时间。Objective To make observation on treating elderly patients with COPD with pulmonary bulla with type II respirato-ry failure with lung protective mechanical ventilation and traditional mechanical ventilation. Methods 42 elderly patients with COPD with pulmonary bulla with type II respiratory failure were randomly divided into two groups A and B. Lung protective me-chanical ventilation in group A and traditional mechanical ventilation was applied in group B. Observed two groups of patients with mechanical ventilation period before and after arterial blood pH,PaO2,PaCO2,SaO2 and complications caused by mechanical ven-tilation. Results There was no statistically significant difference in survival rate in both groups,protective ventilation group in complications,mechanical ventilation time,hospitalization time significantly were less than the traditional mechanical ventilation group. Conclusion For pulmonary bulla in patients with type II respiratory failure,protective mechanical ventilation can reduce the incidence of complication,shorten the time of mechanical ventilation and hospitalization time.

关 键 词：保护性机械通气 肺大泡 呼吸衰竭 小潮气量 

分 类 号：R563.8[医药卫生—呼吸系统]