单纯有创和有创-无创序贯机械通气治疗ICU慢性肺心病急性期合并Ⅱ型呼吸衰竭患者疗效的对比分析  

Effect comparison of invasive mechanical ventilation and invasive-noninvasive sequential mechanical ventilation for acute CCPD patients with type Ⅱ respiratory failure

作　　者：陈天明 陈远平 杨丽平 朱利理 Chen Tianming;Chen Yuanping;Yang Liping;Zhu Lili(Intensive Care Unit,Yuancheng District People's Hospital,Heyuan,Guangdong,517000,China)

机构地区：[1]河源市源城区人民医院重症医学科

出　　处：《当代医学》2019年第35期58-60,共3页Contemporary Medicine

摘　　要：目的分析慢性肺心病急性期(CCPD)、Ⅱ型呼吸衰竭患者在ICU分别行有创通气、有创-无创序贯通气治疗的差异.方法选取2017年1月至2018年6月本院收治的慢性肺心病急性期、Ⅱ型呼吸衰竭患者57例为研究对象,随机分为对照组(n=28)和观察组(n=29).对照组行有创机械通气治疗,观察组行有创-无创序贯机械通气治疗,观察治疗前后两组患者血气、心率等指标水平变化,并分析两组患者机械通气、有创通气时间,比较各组病死率、呼吸机相关性肺炎发生率.结果治疗后观察组PaCO2、心率、PaO2及BNP指标水平变化均显著优于对照组(P<0.05);观察组病死率、VAP发生率明显低于对照组,机械通气、有创通气时间明显短于对照组,差异具有统计学意义(P<0.05).结论CCPD、Ⅱ型呼吸衰竭者治疗时行有创-无创序贯通气治疗,效果理想,临床VAP发生少、病死率低,患者肺功能、心功能恢复良好,值得临床推广.Objective To analyze the difference of invasive ventilation and invasive-noninvasive sequential ventilation in patients with chronic cor pulmonale in acute stage(CCPD) and type Ⅱ respiratory failure in ICU. Methods 57 acute CCPD patients with type Ⅱ respiratory failure treated from January 2017 to June 2018 in our hospital were selected and assigned to control group(n=28) and observation group(n=29). The control group was treated with invasive mechanical ventilation;the observation group was treated with invasive-noninvasive sequential mechanical ventilation. The blood gas indicators, heart rate, mechanical ventilation and invasive ventilation time, fatality rate and incidence rate of ventilator-associated pneumonia(VAP) were investigated. Results After treatment, the values of PaCO2,heart rate and PaO2 between groups were significantly different, BNP contents in the observation group were lower than control group(P<0.05). Compared with control group, the observation group had lower fatality rate and incidence rate of VAP, shorter mechanical ventilation and invasive ventilation time(P<0.05). Conclusion The invasive-noninvasive sequential mechanical ventilation can reduce the incidence rate of VAP and fatality rate, and improve the pulmonary function and cardiac function.

关 键 词：肺心病 序贯通气 呼吸衰竭 心功能 

分 类 号：R47[医药卫生—护理学]