有创、无创机械通气序贯治疗慢性肺心病呼吸衰竭的效果观察  

Effect of invasive and noninvasive sequential mechanical ventilation on respiratory failure of critical cor pulmonale

作　　者：郭淑芳 武嫣斐[1] Guo Shufang;Wu Yanfei(Department of Respiratory and Critical Care Medicine,the First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China)

机构地区：[1]山西医科大学第一医院呼吸与危重症医学科,太原030001

出　　处：《中国基层医药》2019年第21期2561-2564,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：山西省卫生和计划生育委员会中医科研课题(2014ZY01)。

摘　　要：目的观察有创、无创机械通气序贯治疗慢性肺心病呼吸衰竭的临床效果.方法选取山西医科大学第一医院2018年1-3月收治的慢性肺心病呼吸衰竭患者70例为观察对象,采用随机数字表法分为对照组35例、观察组35例.对照组接受有创机械通气治疗,观察组以"肺部感染控制窗(PIC)"为有创通气和无创通气的切换点,给予有创与无创序贯机械通气治疗,比较两组患者的临床相关指标、血气指标、呼吸频率和心率变化情况,分析两组患者的临床疗效.结果观察组有创机械通气时间、总机械通气时间和住院天数分别为(5.16±0.83)d、(7.79±0.63)d、(8.95±0.62)d,均明显短于对照组的(8.42±0.91)d、(11.48±0.95)d、(14.17±0.65)d,差异均有统计学意义(t=15.659、19.151、34.379,均P<0.05);治疗后,观察组血氧分压(PaO2)明显高于对照组[(85.19±5.07)mmHg比(79.95±4.68)mmHg],二氧化碳分压(PaCO2)[(49.85±4.17)mmHg比(53.36±4.82)mmHg]和呼吸频率[(24.43±3.17)次/min比(31.19±4.08)次/min]、心率[(94.43±13.36)次/min比(113.36±17.13)次/min]均明显低于对照组,临床总有效率(91.43%)明显高于对照组(54.29%),差异均有统计学意义(t=4.493、3.258、7.740、4.338,χ2=12.209,均P<0.05).结论对慢性肺心病呼吸衰竭患者实施有创与无创机械通气序贯治疗的临床疗效显著,可促进患者临床症状的改善,缩短患者住院治疗的时间.Objective To observe and analyze the clinical effects of invasive and non-invasive sequential mechanical ventilation in the treatment of respiratory failure in patients with chronic pulmonary heart disease.Methods A total of 70 patients with chronic pulmonary ill heart disease and respiratory failure admitted to the First Hospital of Shanxi Medical University from January 2018 to March 2018 were enrolled in this study.The patients were randomly divided into control group and observation group according to the digital table,with 35 cases in each group.The control group received invasive mechanical ventilation treatment.The observation group used the"pulmonary infection control window(PIC)"as the switching point of invasive ventilation and non-invasive ventilation,and invasive and non-invasive sequential mechanical ventilation were given.The clinical indicators,blood gas indicators,respiratory rate and heart rate changes of the two groups were compared.The clinical efficacy of the two groups were observed to analyze.Results The invasive mechanical ventilation time,total ventilation time and hospitalization days in the observation group were(5.16±0.83)d,(7.79±0.63)d and(8.95±0.62)d,respectively,which were significantly shorter than those in the control group[(8.42±0.91)d,(11.48±0.95)d,(14.17±0.65)d],the differences were statistically significant(t=15.659,19.151,34.379,all P<0.05).After treatment,the PaO2 of the observation group was significantly higher than that of the control group[(85.19±5.07)mmHg vs.(79.95±4.68)mmHg],while the PaCO2[(49.85±4.17)mmHg vs.(53.36±4.82)mmHg],respiratory rate[(24.43±17.13)times/min]in the observation group were significantly lower than those in the control group,and the total effective rate of the observation group(91.43%)was significantly higher than that of the control group(54.29%),the differences were statistically significant(t=4.493,3.258,7.740,4.338,χ2=12.209,all P<0.05).Conclusion The clinical efficacy of invasive and non-invasive sequential mechanical ventilation

关 键 词：肺心病 呼吸功能不全 通气机 机械 呼吸 人工 血气监测 经皮 呼吸 心率 住院时间 临床对照试验 

分 类 号：R54[医药卫生—心血管疾病]