有创-无创序贯机械通气治疗老年重症肺炎患者的效果  

Effects of invasive-noninvasive sequential mechanical ventilation on elderly patients with severe pneumonia

作　　者：侯笑颜 牛建佩[1] HOU Xiaoyan;NIU Jianpei(Department of Critical Care Medicine of the Third People’s Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州市第三人民医院重症医学科,河南郑州450000

出　　处：《中国民康医学》2024年第7期30-33,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察有创-无创序贯机械通气治疗老年重症肺炎患者的效果。方法:选取2022年3月至2023年5月该院收治的80例老年重症肺炎患者进行前瞻性研究,采用随机数字表法将其分为对照组与观察组各40例。对照组采用有创机械通气治疗,观察组采用有创-无创序贯机械通气治疗。比较两组治疗前后肺通气指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气流量峰值(PEF)、FEV1/FVC、平均肺动脉压(mPVP)]水平、血气分析指标[动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、pH值]水平,呼吸机相关肺炎(VAP)发生率和1次拔管成功率。结果:治疗后,两组FVC、FEV1、FEV1/FVC、PEF水平均高于治疗前,观察组高于对照组,两组mPVP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组pH值及PaO_(2)水平均高于治疗前,且观察组高于对照组,两组PaCO_(2)水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组VAP发生率低于对照组,1次拔管成功率高于对照组,差异均有统计学意义(P<0.05)。结论:有创-无创序贯机械通气治疗老年重症肺炎患者,能够有效改善肺通气指标和血气分析指标水平,降低VAP发生率,提高1次拔管成功率,其效果优于有创机械通气治疗。Objective:To observe effects of invasive-noninvasive sequential mechanical ventilation on elderly patients with severe pneumonia.Methods:A prospective study was conducted on 80 elderly patients with severe pneumonia admitted to the hospital from March 2022 to May 2023.They were divided into control group and observation group by using the random number table method,40 cases in each group.The control group received invasive mechanical ventilation treatment,while the observation group received invasive-noninvasive sequential mechanical ventilation treatment.The levels of pulmonary ventilation indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),FEV1/FVC,mean pulmonary artery pressure(mPVP)],and blood gas analysis indicators[arterial partial pressure of carbon dioxide(PaCO_(2)),arterial oxygen pressure(PaO_(2)),pH value]before and after the treatment,the incidence of ventilator associated pneumonia(VAP),and the extubation success rate were compared between two groups.Results:After the treatment,the levels of FVC,FEV1,FEV1/FVC,and PEF in both groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;the levels of mPVP in both groups was lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).The pH value and levels of PaO_(2) in both groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;the PaCO_(2) levels in both groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).Further,the incidence of VAP in the observation group was lower than that in the control group,the one-time extubation success rate was higher than that in the control group,and the differences were statistically

关 键 词：有创-无创序贯机械通气 重症肺炎 肺通气指标 并发症 动脉血气分析指标 

分 类 号：R563.8[医药卫生—呼吸系统]