有创-无创序贯机械通气治疗AECOPD合并Ⅱ型呼吸衰竭的诊治体会  

Experience in Diagnosis and Treatment of Sequential Invasive-noninvasive Mechanical Ventilation in the Treatment of AECOPD with Type Ⅱ Respiratory Failure

作　　者：黄佩荣 

机构地区：[1]晋中市榆次区人民医院呼吸内科,山西晋中030600

出　　处：《中国医药指南》2016年第6期15-16,共2页Guide of China Medicine

摘　　要：目的观察有创-无创序贯机械通气治疗AECOPD合并Ⅱ型呼吸衰竭临床疗效。方法序贯组:选取2013年1月至2015年1月AECOPD患者16例,治疗达肺部感染控制窗后,撤离有创呼吸机,改为无创呼吸机治疗。对照组:选取2010年1月至2012年1月AECOPD患者14例,以SIMV+PSV方式撤机。分析比较两组患者有创机械通气时间、总机械通气时间、总住院时间、呼吸机相关性肺炎(VAP)发生率、再插管率等。结果序贯治疗组有创机械通气时间、总机械通气时间、总住院时间较对照组均缩短,P<0.05。呼吸机相关性肺炎(VAP)发生率、再插管率均低于对照组,P<0.05。结论有创-无创序贯机械通气治疗AECOPD合并Ⅱ型呼吸衰竭较传统机械通气治疗效果好,值得临床推广。Objective To observe the clinical outcome of sequential noninvasive following invasive mechanical ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） complicated with type Ⅱrespiratory failure.Methods A total of 16 patients with AECOPD from January 2013 to January 2015 were enrolled into the sequential group,and after the pulmonary infection was controlled,invasive ventilator was weaned and changed to noninvasive ventilator.For the 14 cases of AECOPD in control group from January 2010 to January 2012,ventilator weaning was performed by synchronized intermittent mandatory ventilation（SIMV） plus pressure support ventilation（PSV）.Indicators as duration of total hospital stay,rate of ventilator associated pneumonia（VAP）,and rate of reintubation.Results Compared with control group,duration of invasive mechanical ventilation,duration of total mechanical ventilation,duration of total hospital stay in sequential group were significantly shortened（P〈0.05）,and rates of VAP and reintubation were lowered（P 〈0.05）.Conclusion Sequential noninvasive following invasive mechanical ventilation in the treatment of AECOPD complicated with type Ⅱ respiratory failure has better clinical outcomes than traditional mechanical ventilation,and this method is worth to populate in clinical application.

关 键 词：AECOPD Ⅱ型呼吸衰竭 有创-无创序贯机械通气 

分 类 号：R563.8[医药卫生—呼吸系统]