有创-无创序贯通气策略在慢性阻塞性肺疾病急性加重期(AECOPD)撤机困难患者中的应用  

Application of strategy of sequential invasive and non-invasive sequential mechanical ventilation in AECOPD patients with weaning difficulty

作　　者：杨静[1] 赵珂[1] 何浩[1] 张丽[1] YANG Jing;ZHAO Ke;HE Hao;et al(Intensive Care Unit,Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Chin)

机构地区：[1]川北医学院附属医院重症医学科,四川南充637000

出　　处：《吉林医学》2018年第5期813-815,共3页Jilin Medical Journal

摘　　要：目的:探讨有创-无创序贯通气策略在慢性阻塞性肺疾病急性加重期(AECOPD)撤机困难患者中的应用。方法:选择2015年9月~2017年8月期间,由川北医学院附属医院重症医学科收治的所有接受有创机械通气撤机困难的AECOPD患者57例,比较有创-无创序贯通气(试验组,n=33)与撤机拔管后给予鼻导管给氧(对照组,n=24)撤机后总机械通气时间、ICU住院时间、总住院时间、48 h再插管率、撤机成功率、院内死亡率。结果:试验组总机械通气时间、ICU住院时间、总住院时间、48 h再插管率、撤机成功率、院内死亡率与对照组相比,差异有统计学意义(P<0.05)。结论:撤机困难AECOPD患者运用有创-无创通气策略可降低48 h再插管率和提高撤机成功率。Objective To study the strategy of sequential invasive and non-invasive sequential mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease patients with weaning difficulty. Method Fifty-seven cases of patients with acute exacerbation of chronic obstructive pulmonary disease with weaning difficulty during September 2015 ～ Augest 2017 from affiliated hospital of North Sichuan Medical College in intensive care unit were selected. Compare the total time of mechanical ventilation,length of stay in intensive care unit,total hospitalization time,48 h re-tracheal intubation rate,withdrawal machine success rate,hospital mortality in the two groups（intervention group,n = 33; control group,n = 24）. Results In invasive non-invasive treatment group,the total time of mechanical ventilation,length of stay in intensive care unit,total hospitalization time,48h re-tracheal intubation rate,withdrawal machine success rate and hospital mortality compared to the control group,the differences were statistically significant（P〈0. 05）. Conclusion The usages of sequential invasive-noninvasive mechanical ventilation strategy in patients with acute exacerbation of chronic obstructive pulmonary disease with weaning difficulty can reduce 48 h intubation rate and improve the successful rate of weaning.

关 键 词：慢性阻塞性肺疾病急性加重期(AECOPD) 有创-无创序贯通气 撤机 

分 类 号：R563.9[医药卫生—呼吸系统]