有创-无创序贯机械通气对急性肺心病患者血气分析及救治结果的影响  

Effects of Invasive Non-invasive Sequential Mechanical Ventilation on Blood Gas Analysis and Treatment Results of Patients with Acute Cor Pulmonale

作　　者：刘知远 LIU Zhi-yuan(Tianjin Dongli Hospital,Tianjin 300011,China)

机构地区：[1]天津市东丽医院,天津300011

出　　处：《罕少疾病杂志》2024年第1期42-43,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨有创-无创序贯机械通气在急性肺心病患者中的治疗效果。方法选取2021年11月-2022年11月我院收治的248例高原急性肺心病患者,按随机数字表法分为两组,各124例。对照组予以有创机械通气治疗,观察组行有创-无创序贯机械通气。治疗7d后比较两组血气分析指标、肺功能指标、机械通气时间及住院时间、救治效果。结果观察组治疗后血氧分压(PaO_(2))为(80.69±6.25)mmHg,高于对照组的(73.54±6.19)mmHg,二氧化碳分压(PaCO_(2))为(45.69±4.84)mmHg,低于对照组的(50.07±5.12)mmHg(P<0.05);观察组治疗后用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC分别为(3.26±0.55)L、(2.21±0.42)L、(67.79±6.15)%,高于对照组的(2.87±0.49)L、(1.78±0.37)L、(62.02±5.89)%(P<0.05);观察组机械通气时间、住院时间分别为(12.32±1.42)d、(17.35±2.04)d,短于对照组的(15.63±1.88)d、(21.27±2.25)d,VAP发生率低于对照组(P<0.05);两组病死率相比(P>0.05)。结论有创-无创序贯机械通气可提高急性肺心病治疗效果,加快血气指标复常,减轻肺功障碍,缩短机械通气及住院时间,且VAP风险低。Objective To investigate the therapeutic effect of invasive and noninvasive sequential mechanical ventilation in patients with acute pulmonary heart disease.Methods A total of 248 patients with high altitude acute pulmonary heart disease treated in our hospital from November 2021 to November 2022 were selected and divided into two groups with 124 cases each according to random number table method.The control group was treated with invasive mechanical ventilation,and the observation group was treated with invasive noninvasive mechanical ventilation.After 7 days of treatment,blood gas analysis indexes,lung function indexes,mechanical ventilation time,hospital stay and treatment effect were compared between the two groups.Results After treatment,the blood oxygen partial pressure(PaO_(2))of the observation group was(80.69±6.25)mmHg,which was higher than that of the control group(73.54±6.19)mmHg,and the PaCO_(2) was(45.69±4.84)mmHg.It was lower than that of control group(50.07±5.12)mmHg(P<0.05);In the observation group,forced vital capacity(FVC),forced expiratory volume(FEV1)and FEV1/FVC after treatment were(3.26±0.55)L,(2.21±0.42)L,(67.79±6.15)%,respectively.Higher than control group(2.87±0.49)L,(1.78±0.37)L,(62.02±5.89)%(P<0.05);The mechanical ventilation time and hospitalization time in the observation group were(12.32±1.42)d and(17.35±2.04)d,which were shorter than those in the control group(15.63±1.88)d and(21.27±2.25)d,and the incidence of VAP was lower than that in the control group(P<0.05).The fatality rate of the two groups was compared(P>0.05).Conclusion Invasive and noninvasive sequential mechanical ventilation can improve the therapeutic effect of acute pulmonary heart disease,accelerate the normalization of blood gas index,reduce lung function disorders,shorten mechanical ventilation and hospital stay,and reduce the risk of VAP.

关 键 词：急性肺心病 机械通气 序贯通气 血气分析 

分 类 号：R541.5[医药卫生—心血管疾病]