有创-无创序贯机械通气对重症肺炎合并呼吸衰竭患者的影响  

Effects of Invasive Non-invasive Sequential Mechanical Ventilation on Patients with Severe Pneumonia Complicated with Respiratory Failure

作　　者：杨娟 郑文博 YANG Juan;ZHENG Wenbo(Quanzhou First Hospital,Quanzhou 362000,China;不详)

机构地区：[1]泉州市第一医院,福建泉州362000

出　　处：《中外医学研究》2023年第18期10-14,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨有创-无创序贯机械通气在重症肺炎(SP)合并呼吸衰竭患者中的应用效果。方法:选取2020年6月—2022年6月泉州市第一医院收治的86例SP合并呼吸衰竭患者。根据随机数表法将其分为对照组和观察组,各43例。对照组给予有创机械通气治疗。观察组给予有创-无创序贯机械通气治疗。比较两组临床相关指标,治疗前及治疗7 d后血气指标、炎症因子、心肌损伤标志物,治疗前和治疗14 d后的肺功能指标及并发症。结果:观察组氧疗时间、有创通气时间及住院时间分别为(12.36±1.45)d、(5.25±1.06)d、(18.36±2.14)d,均短于对照组的(20.41±2.35)d、(13.52±1.72)d、(25.44±2.43)d,差异有统计学意义(P<0.05)。治疗7 d后,观察组血氧分压(PaO_(2))为(87.69±6.25)mmHg(1 mmHg=0.133 kPa),高于对照组的(80.54±6.19)mmHg,二氧化碳分压(PaCO_(2))为(42.69±4.24)mmHg,低于对照组的(46.07±4.32)mmHg,差异有统计学意义(P<0.05)。治疗14 d后,观察组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC%分别为(2.21±0.42)L、(3.26±0.55)L、(67.79±6.15)%,高于对照组的(1.78±0.37)L、(2.87±0.49)L、(62.02±5.89)%,差异有统计学意义(P<0.05)。治疗7 d后,观察组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)水平分别为(63.58±6.44)pg/mL、(1.58±0.23)μg/mL、(6.75±1.12)×10^(9)/L,均低于对照组的(71.42±7.27)pg/mL、(2.43±0.35)μg/mL、(9.48±1.37)×10^(9)/L,差异有统计学意义(P<0.05)。治疗7 d后,观察组心肌肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)、心钠肽水平(ANP)分别为(0.35±0.06)ng/mL、(70.63±6.25)pg/mL、(142.32±8.51)pg/mL,均低于对照组的(0.46±0.11)ng/mL、(78.59±6.34)pg/mL、(155.76±10.12)pg/mL,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:有创-无创序贯机械通气可加快SP合并呼吸衰竭患者血气复常,减轻肺部炎症反应,降低心�Objective:To investigate the application effect of invasive non-invasive sequential mechanical ventilation in severe pneumonia(SP)patients with respiratory failure.Method:A total of 86 patients with SP complicated with respiratory failure admitted to Quanzhou First Hospital from June 2020 to June 2022 were selected.They were divided into control group and observation group according to random number table method,with 43 cases in each group.The control group was given invasive mechanical ventilation therapy.The observation group was given invasive non-invasive sequential mechanical ventilation therapy.The clinical related indexes,blood gas indexes,inflammatory factors,myocardial injury markers before and 7 d after treatment,pulmonary function indexes before and 14 d after treatment and complications were compared between the two groups.Result:The oxygen therapy time,invasive ventilation time and hospitalization time in the observation group were were(12.36±1.45)d,(5.25±1.06)d and(18.36±2.14)d,which were shorter than(20.41±2.35)d,(13.52±1.72)d and(25.44±2.43)d in the control group,the differences were statistically significant(P<0.05).After 7 d of treatment,the blood oxygen partial pressure(PaO_(2))of the observation group was(87.69±6.25)mmHg(1 mmHg=0.133 kPa),which was higher than(80.54±6.19)mmHg of the control group,and the partial pressure of carbon dioxide(PaCO_(2))was(42.69±4.24)mmHg,which was lower than(46.07±4.32)mmHg of the control group,the differences were statistically significant(P<0.05).After 14 d of treatment,forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC%were(2.21±0.42)L,(3.26±0.55)L and(67.79±6.15)%respectively,which were higher than(1.78±0.37)L,(2.87±0.49)L,(62.02±5.89)%in the control group,the differences were statistically significant(P<0.05).After 7 d of treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and white blood cell count(WBC)in the observation group were(63.58±6.44)pg/mL,(1.58±0.23)μg/mL,(6.75±1.12)

关 键 词：重症肺炎 呼吸衰竭 有创-无创序贯机械通气 血气指标 

分 类 号：R563[医药卫生—呼吸系统]