有创-无创序贯机械通气治疗非COPD急性呼吸衰竭的临床效果观察  

Clinical effect observation of invasive-noninvasive sequential mechanical ventilation in the treatment of non-COPD with acute respiratory failure

作　　者：王剑[1] 

机构地区：[1]南昌大学上饶医院,江西上饶330000

出　　处：《中国当代医药》2015年第25期31-33,共3页China Modern Medicine

摘　　要：目的探讨有创-无创序贯机械通气治疗非COPD急性呼吸衰竭的临床效果。方法选取本院2013年6月~2014年10月收治的78例非COPD急性呼吸衰竭患者作为研究对象,随机分为对照组和实验组。对照组给予常规有创机械通气治疗,实验组给予有创-无创序贯机械通气治疗。比较两组治疗前后的呼吸频率、心率、动脉血气指标及总住院时间、机械通气时间、撤机成功率、呼吸机相关性肺炎（VAP）发生率和住院死亡率。结果两组治疗后的呼吸频率、心率、Pa CO2水平显著低于治疗前,Pa O2水平显著高于治疗前,差异有统计学意义（P〈0.05）。实验组治疗后的Pa CO2水平显著低于对照组治疗后,Pa O2水平显著高于对照组治疗后,差异有统计学意义（P〈0.05）。两组的撤机成功率和住院死亡率比较,差异无统计学意义（P〉0.05）。实验组的总住院时间、机械通气时间显著短与对照组,呼吸机相关性肺炎（VAP）发生率显著低于对照组,差异有统计学意义（P〈0.05）。结论有创-无创序贯机械通气治疗可以明显改善非COPD急性呼吸衰竭患者的临床症状,缩短治疗时间,降低VAP发生率,值得临床推广应用。Objective To explore the clinical effect of invasive-noninvasive sequential mechanical ventilation in the treatment of non-COPD with acute respiratory failure. Methods 78 non-COPD patients with acute respiratory failure in our hospital from June 2013 to October 2014 were selected and randomly divided into the control group and the experiment group.The control group was given conventional invasive mechanical ventilation treatment,the experiment group was given invasive-noninvasive sequential mechanical ventilation treatment.The respiratory rate,heart rate,arterial blood gas indices,total length of hospital stay,mechanical ventilation time,ventilator weaning success rate,incidence of ventilator-associated pneumonia（VAP） and in-hospital mortality rate before and after treatment in two groups was compared respectively. Results The respiratory rate,heart rates,the level of Pa CO2 in two groups after treatment was lower than that before treatment,the level of Pa O2 in two groups after treatment was higher than that before treatment,with significant difference（P0.05）.The level of Pa CO2 in the experiment group after treatment was lower than that in the control group after treatment,the level of Pa O2 in the experiment group after treatment was higher than that in the control group after treatment,with significant difference（P〈0.05）.There was no significant difference of the ventilator weaning success rate and in-hospital mortality rate between two groups（P〈0.05）.The total length of hospital stay,mechanical ventilation time and the incidence rate of VAP in the experiment group was lower than in the control group,with significant difference（P 〈0.05）. Conclusion Invasive-noninvasive sequential mechanical ventilation treatment can significantly improve clinical symptom of the patients with non-COPD acute respiratory failure,shorten the treatment time and reduce incidence rate of VAP,it is worthy of clinical promotion and application.

关 键 词：有创-无创序贯机械通气 非慢性阻塞性肺疾病 急性呼吸衰竭 

分 类 号：R459.9[医药卫生—治疗学]