气道管理小组干预对有创-无创序贯机械通气治疗COPD伴呼吸衰竭患者并发症发生率的影响  

Effect of airway management team intervention on complications rates in patients with COPD and respiratory failure underwent sequential invasive-noninvasive mechanical ventilation

作　　者：王涵 张大维 程思思 郭晓勤[2] WANG Han;ZHANG Dawei;CHENG Sisi(Intensive Care Unit,Emergency General Hospital,Beijing 100028,China)

机构地区：[1]应急管理部应急总医院重症监护室,北京市100028 [2]中国中医科学院眼科医院屈光手术科

出　　处：《河北医药》2023年第9期1387-1390,共4页Hebei Medical Journal

摘　　要：目的探讨气道管理小组干预对行有创-无创序贯机械通气治疗慢性阻塞性肺疾病(COPD)伴呼吸衰竭患者并发症发生率的影响。方法选择2019年1月至2021年5月收治的行有创-无创序贯机械通气治疗COPD伴呼吸衰竭患者86例,随机数字表法分为对照组(n=43,给予常规干预)和观察组(n=43,气道管理小组干预),对比2组患者住ICU时间、机械通气时间、有创通气时间、住院时间、病死率、并发症发生率(VAP、下肢静脉栓塞、肺部感染)、再插管率、气道湿化满意度,对比干预前后2组患者血气指标[酸碱度(pH)、氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、二氧化碳分压(PaCO_(2))]。结果观察组住ICU时间、机械通气时间、有创通气时间、住院时间短于对照组,(t=2.809、2.597、2.716、3.354,P=0.006、0.011、0.008、0.001)。观察组干预7 d后pH值、PaO_(2)、SaO_(2)高于对照组(t=2.055、2.538、3.128,P=0.043、0.013、0.002),PaCO_(2)水平低于对照组(t=3.268,P=0.002)。观察组病死率、并发症发生率、再插管率低于对照组(χ^(2)=4.440、7.242、4.914,P=0.035、0.007、0.027),气道湿化满意度高于对照组(χ^(2)=5.108,P=0.024)。结论气道管理小组干预能够降低并发症发生率,改善血气分析指标,缩短患者病程,提高气道湿化满意度,值得推广。Objective To explore the effect of airway management team intervention on complications rates in patients with chronic obstructive pulmonary disease(COPD)and respiratory failure underwent sequential invasive-noninvasive mechanical ventilation.Methods A total of 86 patients with COPD and respiratory failure underwent sequential invasive-noninvasive ventional strategy in our hospital from January 2019 to May 2021 were enrolled.They were randomized 1∶1 to receive to routine intervention(the control group)or airway management team intervention(the observation group).Duration to intensive care units(ICU),mechanical ventilation,and invasive ventilation,length of stay,mortality,complications rates including ventilator-associated pneumonia,lower extremity vein embolism,pulmonary infection,re-intubation rate,as well as satisfaction to airway humidification were compared between groups.Blood gas indexes before and after intervention,including pH,partial pressure of oxygen(PaO_(2)),arterial oxygen(SaO_(2)),and partial pressure of carbon dioxide(PaCO_(2))were compared.Results Duration to ICU,mechanical ventilation,and invasive ventilation,length of stay in the observation group were significantly shorter than those in the control group(t=2.809,2.597,2.716,and 3.354,P=0.006,0.011,0.008,and 0.001,respectively).After 7 days of intervention,pH,PaO_(2) and SaO_(2) in the observation group were significantly higher than those in the control group(t=2.055,2.538,and 3.128,P=0.043,0.013,and 0.002,respectively),and PaCO_(2) was significantly lower than that in the control group(t=3.268,P=0.002).The mortality,incidence of complications and reintubation rate of the observation group were significantly lower than those of the control group(χ^(2)=4.440,7.242,and 4.914,P=0.035,0.007,and 0.027,respectively),and the satisfaction of airway humidification of the observation group was significantly higher than that of the control group(χ^(2)=5.108,P=0.024).Conclusion Airway management team intervention can reduce the incidence of complicati

关 键 词：气道管理小组干预 有创-无创序贯机械通气 慢性阻塞性肺疾病 呼吸衰竭 并发症发生率 

分 类 号：R563[医药卫生—呼吸系统]