有创-无创序贯性机械通气治疗重症慢性阻塞性肺疾病呼吸衰竭患者的临床效果  

Clinical Effect of Invasive-Noninvasive Sequential Mechanical Ventilation on Patients With Severe Chronic Obstructive Pulmonary Disease and Respiratory Failure

作　　者：赵帅 Zhao Shuai(Emergency Department,Kaifeng Hospital of traditional Chinese Medicine,Kaifeng 475000,China)

机构地区：[1]开封市中医院急诊科,河南开封475000

出　　处：《哈尔滨医药》2021年第6期6-8,共3页Harbin Medical Journal

摘　　要：目的探讨有创-无创序贯性机械通气治疗重症慢性阻塞性肺疾病呼吸衰竭患者的临床效果。方法选取重症慢性阻塞性肺疾病呼吸衰竭患者86例,按随机数字表法分为试验组(n=43)和对照组(n=43),对照组予以持续有创机械通气治疗,试验组予以有创-无创序贯性机械通气治疗。对比两组机械通气时间、住院时间、治疗前后血气指标[动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))]、肺功能[呼气峰流速(PEF)、第一秒用力呼气容积(FEV1)]及呼吸机相关性肺炎(VAP)发生率。结果试验组有创机械通气时间、总机械通气时间、住院时间均短于对照组(P<0.05);治疗后,试验组PaO_(2)较对照组高,PaCO_(2)较对照组低(P<0.05);治疗后,试验组PEF、FEV1均较对照组高(P<0.05);VAP发生率2.33%与对照组11.63对比无统计学差异(P>0.05)。结论有创-无创序贯性机械通气治疗重症慢性阻塞性肺疾病呼吸衰竭患者,可改善血气指标,改善患者肺功能,并能缩短机械通气时间,预防VAP,加快患者康复进程,缩短住院时间。Objective To investigate the clinical effect of invasive-noninvasive sequential mechanical ventilation in the treatment of severe chronic obstructive pulmonary disease patients with respiratory failure.Methods A total of 86 patients with severe chronic obstructive pulmonary disease and respiratory failure were selected and divided into experimental group(n=43)and control group(n=43)according to the random number table.The control group received continuous invasive mechanical ventilation,and the experimental group received invasive-noninvasive sequential mechanical ventilation.The mechanical ventilation time,hospitalization time,blood gas indexes(PaO_(2),PaCO_(2)),lung function(PEF,FEV1)and the incidence of ventilator-associated pneumonia(VAP)before and after treatment were compared between the two groups.Results The invasive mechanical ventilation time,total mechanical ventilation time,and hospital stay in the experimental group were shorter than those of the control group(P<0.05),after treatment,the experimental group had higher PaO_(2) and lower PaCO_(2) than the control group(P<0.05).After treatment,PEF and FEV1 in the experimental group were higher than those in the control group(P<0.05).The incidence of VAP of the experimental group and the control group were 2.33%(1/43)and 11.63%(5/43),there was no significant difference in comparison(P>0.05).Conclusion Invasive-noninvasive sequential mechanical ventilation for severe chronic obstructive pulmonary disease patients with respiratory failure can improve blood gas indicators,improve patients’pulmonary function,shorten the time of mechanical ventilation,prevent VAP,speed up the patient’s recovery process,and shorten the hospital stay.

关 键 词：重症慢性阻塞性肺疾病呼吸衰竭 有创-无创序贯性机械通气 机械通气时间 血气指标 

分 类 号：R457.2[医药卫生—治疗学]