有创呼吸机不同通气模式对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的临床应用效果  

Clinical application effect of different ventilation modes of invasive ventilator on patients with chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure

作　　者：霍灵月 杨海荣 高然 HUO Ling-yue;YANG Hai-rong;GAO Ran(Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院,北京100038

出　　处：《实用医院临床杂志》2023年第4期123-126,共4页Practical Journal of Clinical Medicine

基　　金：北京市科技计划项目(编号:Z211100012011245)。

摘　　要：目的探讨对慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭(RF)患者使用不同通气模式进行机械通气的临床治疗效果。方法122例COPD合并Ⅱ型RF患者,采用随机信封法分为压力支持通气(PCV)组和适应性支持通气(ASV)组各61例。两组均给予有创呼吸机不同通气模式治疗5 d。比较两组治疗前后呼吸力学指标、炎症因子,记录不良反应发生情况。结果治疗5 d后,两组患者各项炎症因子、呼气频率(f)、气道阻力(RAW)水平均较治疗前降低,ASV组低于PCV组(P<0.05);各项血气指标水平、潮气量(VT)均较治疗前升高,ASV组高于PCV组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在COPD合并Ⅱ型RF患者临床治疗中应用两种通气模式均可有效改善患者通气状态,且可有效降低患者机体炎症反应水平,但ASV通气模式对患者各项指标的改善效果更佳。Objective To explore the clinical therapeutic effects of mechanical ventilation with different ventilation modes in the treatment of patients with chronic obstructive pulmonary disease(COPD)complicated with typeⅡrespiratory failure(RF).Methods One hundred and twenty-two patients with COPD and typeⅡRF were selected.The patients were classified into a pressure controlled ventilation(PCV)group and an adaptive support ventilation(ASV)group by the random envelope method,61 in each group.Both groups were treated for 5 days with different ventilation modes of invasive ventilator.The respiratory mechanics indicators and inflammatory factors were compared before and after treatment between the two groups.The adverse reactions were recorded.Results After 5 days of treatment,the inflammatory factors,expiratory frequency(f)and airway resistance(RAW)in both groups were reduced compared with those before treatment,and the indicators in the ASV group were lower than those in the PCV group(P<0.05).The blood gas indicators and tidal volume(VT)were enhanced compared to before treatment,and the indicators were higher in the ASV group than those in the PCV group(P<0.05).There were no statistical difference in the incidence rates of adverse reactions between the two groups(P>0.05).Conclusions In the clinical treatment of COPD with type II RF,the two ventilation modes can effectively improve the ventilation status.They can effectively reduce the inflammatory response.However,ASV ventilation mode is better for the improvement of various indicators in these patients.

关 键 词：慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 通气模式 呼吸力学 血气指标 

分 类 号：R563[医药卫生—呼吸系统]