不同撤机方式对机械通气治疗COPD并呼吸衰竭患者的临床疗效比较  

The Clinical Efficacy Comparison of Different Weaning Modes in the Treatment of COPD with Respiratory Failure Using Invasive Mechanical Ventilation

作　　者：龙贵华 廖彧 巫建芳 Long Guihua(Department of ICU,No.3 Affiliated Hospital of Guangdong Medical University（Shunde Longjiang Hospital）,Foshan 528318)

机构地区：[1]广东医科大学附属第三医院(顺德龙江医院)重症医学科,佛山528318

出　　处：《数理医药学杂志》2018年第10期1483-1484,共2页Journal of Mathematical Medicine

摘　　要：目的:比较不同撤机方式对慢性阻塞性肺疾病(COPD)并呼吸衰竭患者行机械通气的临床疗效。方法:选取行机械通气治疗的COPD并呼吸衰竭患者72例,随机分为A组、B组、C组,每组24例。A组采用传统撤机方法,B组与C组分别在呼吸系统功能评分为3~4分,5~6分时撤机,比较3组患者撤机状况、机械通气时间、入住ICU时间及并发症发生率。结果:直接撤机成功率比较:B组>C组>A组(P<0.05);患者机械通气时间、入住ICU时间比较:B组<C组<A组(P<0.05);患者肺部气压伤、呼吸机相关性肺炎(VAP)发生率比较:B组<C组<A组(P<0.05)。结论:呼吸系统功能评分3~4分作为呼吸机撤机指标可缩短机械通气与入住ICU时间,降低VAP发生率,且不影响撤机成功率。Objective： To compare the clinical therapeutic effect of different weaning modes in the treatment of chronic obstructive pulmonary disease（COPD） with respiratory failure using invasive mechanical ventilation. Methods： A total of 72 COPD patients accompanied with respiratory failure were selected, all of them were treated with mechanical ventilation, and they were randomly divided into A, B and C group,24 cases in each group. Patients of A group were treated with ventilator weaning according to traditional method, patients of B and C group were treated with ventilator weaning when respiratory system function score was 3～4, 5～6, respectively. Ventilator weaning results, including ventilator weaning status, duration of mechanical ventilation, ICU stay time and incidence of complications were compared. Results： Directly successful ventilator weaning rate： B grou P 〉C grou P 〉A group （ P 〈0.05）; Duration of mechanical ventilation and ICU stay time： B grou P 〈C grou P 〈A group（ P 〈0.05）; incidence of lung barotraumas and VAP： B grou P 〈C grou P 〈A group（ P 〈0.05）. Conclusion： Ventilator weaning when respiratory system function score is 3～4 can effectively shorten the duration of mechanical ventilation or ICU stays, reduce the incidence of VAP, without affecting successful ventilator weaning rate.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 呼吸机撤机 

分 类 号：R563.8[医药卫生—呼吸系统]