有创-无创序贯机械通气治疗肺结核合并呼吸衰竭的临床效果观察  

Clinical effect of invasive and non-invasive sequential mechanical ventilation in treatment of pulmonary tuberculosis patients with respiratory failure

作　　者：张瀚文 

机构地区：[1]黑龙江省传染病防治院ICU病房,黑龙江哈尔滨150500

出　　处：《中国医药科学》2015年第18期146-148,共3页China Medicine And Pharmacy

摘　　要：目的探讨有创-无创序贯机械通气治疗肺结核合并呼吸衰竭的临床效果。方法回顾性分析我院2013年1月~2015年1月住院的69例因肺结核继发呼吸衰竭患者的临床资料,根据患者的治疗方法,将其分为对照组（n=46）和观察组（n=23）,对照组采用单纯有创通气治疗,观察组患者接受有创与无创序贯治疗,观察两组患者的疗效。结果观察组患者的有创通气时间、总通气时间、VAP发生率及入住ICU的时间较对照组显著减少（P〈0.05）。观察组8例患者出现气道损伤,无气管软化等严重并发症,死亡2例。对照组患者中28例出现气道损伤,死亡14例。观察组患者气道损伤与病死率明显低于对照组,差异具有统计学意义（P〈0.05）。结论有创-无创序贯性机械通气治疗肺结核并发呼吸衰竭患者,可减少有创通气时间,增加患者的舒适度,降低并发症的发生,缩短了住院时间并减少了临床治疗费用,值得临床推广与使用。Objective To explore the clinical efficacy of invasive and non-invasive sequential mechanical ventilation in treatment of pulmonary tuberculosis patients with respiratory failure. Methods The clinical data of 69 patients with pulmonary tuberculosis with respiratory failure, who were in hospital from January 2013 to January 2015, were retrospectively analyzed. According to the method of treatment, the patients were divided into control group（n=46） and observation group（n=23）. The control group was treated with noninvasive ventilation, and the observation group was treated with noninvasive and noninvasive treatment. The efficacy of the two groups was observed. Results The time of invasive ventilation, total ventilation time, VAP incidence and the time to stay in ICU of observation group were significantly less than those of control group（P〈0.05）.There were 8 cases of patients with airway injury, no tracheal softening and other serious complications, and 2 cases of death in the observation group. In the control group, 28 patients had airway injury and 14 died. The airway injury and mortality in the observation group were significantly lower than those in the control group, the difference was statistically significant（P〈0.05）. Conclusion Noninvasive sequential mechanical ventilation in treatment of pulmonary tuberculosis patients with respiratory failure can reduce the time of invasive ventilation, increase patient comfort, reduce the occurrence of complications, shorten the length of hospital stay and reduce the cost of clinical treatment, it is worthy of clinical promotion and use.

关 键 词：肺结核 肺部感染控制窗 无创性机械通气 呼吸衰竭 

分 类 号：R563.8[医药卫生—呼吸系统]