慢性阻塞性肺病并呼吸衰竭患者机械通气撤机指标的临床探讨  

Clinical exploration of weaning indexes of mechanical ventilation in patients with chronic obstructive pulmonary disease combined with respiratory failure

作　　者：黄响玲[1] 钟祥柱[1] 陶飞[1] 吴晓弟 

机构地区：[1]广东医学院附属佛山禅城医院内科,广东佛山528031

出　　处：《中国当代医药》2015年第2期25-26,29,共3页China Modern Medicine

摘　　要：目的：探究慢性阻塞性肺病并呼吸衰竭患者机械通气的撤机指标。方法选取本院2012年3月～2014年3月重症监护病房80例慢性阻塞性肺病并呼吸衰竭患者作为研究对象，检测通气时间〉72 h的患者达到临床脱机标准后血气分析、呼吸力学以及肺功能的改变情况。结果成功撤机47例（成功组），失败33例（失败组）。两组pH、PaCO2、PaO2、动态顺应性、平均气道阻力、氧合指数比较，差异均无统计学意义（P〉0.05）。两组肺活量/潮气量、最大吸气负压及浅快呼吸指数比较，差异均有统计学意义（P〈0.05）。结论综合肺功能指标（肺活量/潮气量、最大吸气负压及浅快呼吸指数）可用于指导长期通气慢性阻塞性肺病并呼吸衰竭患者选择脱机的时机，值得临床推广应用。Objective To explore the weaning indexes of mechanical ventilation in patients with chronic obstructive pulmonary disease （COPD）combined with respiratory failure. Methods 80 patients with COPD and respiratory failure in our hospital from March 2012 to March 2014 were selected as research objects.Blood gas analysis,breathing mechanics and pulmonary function were tested in patients whose ventilation period was over 72 hours and who met the criteria of clinical weaning. Results Successful weaning was in 47 cases （successful group）and failure in 33 cases （failure group）. pH,PaCO2,PaO2,dynamic adaptation,airway resistance and oxygenation index in two groups was compared respectively, with no statistical difference （P〉0.05）.Indexes of vital capacity per tidal volume,peak inspiratory negative pressure and rapid shallow respiration in two groups was compared respectively,with statistical difference（P〈0.05）. Conclusion Com-prehensive pulmonary function indexes of vital capacity per tidal volume,peak inspiratory negative pressure and rapid shallow respiration can be selected to judge the appropriate time for weaning in long-term ventilation patients with COPD combined with respiratory failure,which is worthy of clinical expansion and application.

关 键 词：慢性阻塞性肺病 呼吸衰竭 机械通气 撤机指标 

分 类 号：R563.8[医药卫生—呼吸系统]