肺部感染控制窗为切换点行序贯通气治疗重症肺炎合并呼吸衰竭疗效观察  

The clinical effect of pulmonary infection control window for sequence ventilation on treatment of severe pneumonia with respiratory failure

作　　者：邵晓云[1] 齐燕[1] 

机构地区：[1]绍兴第二医院重症监护室,浙江省绍兴312000

出　　处：《中国基层医药》2015年第18期2814-2816,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨肺部感染控制窗为切换点行序贯通气治疗重症肺炎合并呼吸衰竭临床疗效。方法选择重症肺炎并发呼吸衰竭患者102例，采用随机数字表法将所有患者分为对照组和观察组，各51例，观察组应用肺部感染控制窗为切换点行序贯通气治疗；对照组常规进行序贯通气治疗。主要观察指标为通气前后血氧分压（PaO2）、二氧化碳分压（PaCO2）和血氧饱和度（SaO2）的变化、两组患者相关治疗时间和症状改善时间及呼吸机相关性肺炎（VAP）等并发症结果。结果观察组通气后 PaO2和 SaO2分别为（75．60±2．89）mmHg和（0．78±0．09），均高于对照组通气后（70．48±3．16）mmHg 和（0．71±0．11），且两组通气后均高于治疗前，差异均有统计学意义（t ＝11．30、10．92、13．26、14．08，均 P ＜0．05）；观察组通气后 PaCO2为（49．21±3.22）mmHg，低于对照组通气后的（54．35±3．82）mmHg，且两组治疗后均低于治疗前，差异均有统计学意义（t ＝12．44、11．85、14．16、13．42，均 P ＜0．05）；观察组患者机械通气总时间、呼吸困难缓解时间、肺部啰音消失时间和住院时间分别为（5．24±1．83）d、（38．13±2．91）h、（6．72±0．40）d 和（15．33±3．18）d，均低于对照组，差异均有统计学意义（t ＝9．87、10．21、10．46、11．08，均 P ＜0．05）；观察组总的不良反应及病死率为9.80％，低于对照组的19．61％（χ^2＝9．85，P ＜0．05）。结论肺部感染控制窗为切换点行序贯通气治疗重症肺炎合并呼吸衰竭临床效果较好，能够显著提高肺功能并改善预后，降低患者并发症的发生。Objective To explore the clinical effect of pulmonary infection control window for sequence ven-tilation on treatment of severe pneumonia with respiratory failure,and to observe and analyze the prognosis.Methods 102 severe pneumonia patients complicated with respiratory failure were selected.They were divided into the observation group and the control group by the random number table method.The patients of the observation group were treated with pulmonary infection control window for sequence ventilation treatment,the control group were treated with conven-tional sequence ventilation treatment.The change of blood oxygen partial pressure（PaO2 ）,carbon dioxide partial pres-sure（PaCO2 ）and blood oxygen saturation （SaO2 ）before and after ventilation,and the treatment time and symptoms improve time and the complications such as ventilator associated pneumonia（VAP）of the two groups were observed. Results PaO2 and SaO2 of the observation group after the ventilation were （75.60 ±2.89）mmHg and （0.78 ± 0.09）,which were higher than control group after the ventilation （70.48 ±3.16）mmHg and （0.71 ±0.11）,and data of two groups after ventilation were higher than those before the treatment,differences were statistically significant （t =11.30,10.92,13.26,14.08,all P 〈0.05）.PaCO2 of the observation group after the ventilation was 49.21 ±3.22 mmHg, which was lower than that of control group after the ventilation of 54.35 ±3.82 mmHg,and data of two groups after treatment was lower than before treatment,the differences were statistically significant（t =12.44,11.85,14.16, 13.42,all P 〈0.05）.The total mechanical ventilation time of the observation group,respiratory difficulty relief time, lung then disappear time and hospital stay time were （5.24 ±1.83）d,（38.13 ±2.91 ）h,（6.72 ±0.40）d and （15.33 ±3.18）d,which were lower than those of control group,the differences were statistically significant （t =9.87,10.21,10.46,11.08,all P 〈0.05）.The general adverse reaction

关 键 词：肺炎 呼吸功能不全 时间因素 通气机 机械 

分 类 号：R563[医药卫生—呼吸系统]