不同序贯通气转换标准在呼吸衰竭患者中的应用价值分析  

Application Value of Different Sequence through Gas Conversion Standard in Patients with Respiratory Failure

作　　者：秦惠 Qin Hui(Department of Critical Care Medicine,Changshu Second People's Hospital,Changshu 215500,Jiangsu Province,China)

机构地区：[1]常熟市第二人民医院重症医学科,江苏常熟215500

出　　处：《中外医药研究》2024年第16期24-26,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析不同序贯通气转换标准在呼吸衰竭患者中的应用价值。方法:选取2021年9月—2023年11月常熟市第二人民医院收治的需行机械通气治疗的呼吸衰竭患者80例作为研究对象,随机分为对照组与观察组,各40例。两组均行有创机械通气与无创正压通气序贯治疗,对照组以肺部感染控制窗(PICW)为转换标准,观察组以PICW联合自主呼吸试验(SBT)为转换标准。比较两组血气指标、炎性因子水平、并发症发生率及再插管率。结果:通气转换时、通气治疗结束时,两组动脉血氧分压升高,动脉血二氧化碳分压降低,观察组优于对照组,差异有统计学意义(P<0.05);通气转换时、通气治疗结束时,两组白细胞介素-17、白细胞介素-4、肿瘤坏死因子-α水平降低,观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P=0.043);观察组再插管率低于对照组,差异有统计学意义(P=0.023)。结论:PICW联合SBT转换标准用于呼吸衰竭患者机械通气中的效果显著,有助于患者恢复血气指标水平,改善炎性因子水平,降低并发症发生率与再插管率。Objective:To analyze the application value of different sequence through gas conversion standards in patients with respiratory failure.Methods:A total of eighty patients with respiratory failure requiring mechanical ventilation treatment admitted to Changshu Second People's Hospital from September 2021 to November 2023 were selected as the study objects and randomly divided into control group and observation group,with forty patients in each group.Both groups received invasive mechanical ventilation and non-invasive positive pressure ventilation sequential treatment.Pulmonary infection control window(PICW)was used as the conversion standard in control group,and PICW combined with spontaneous breathing test(SBT)was used as the conversion standard in observation group.Blood gas index,inflammatory factor level,complication rate and reintubation rate were compared between the two groups.Results:At the time of ventilation conversion and the end of ventilation treatment,the partial pressure of arterial blood oxygen increased and the partial pressure of arterial blood carbon dioxide decreased in both groups,and the observation group was better than the control group,the difference was statistically significant(P<0.05);the levels of interleukin-17,interleukin-4 and tumor necrosis factor-αin the two groups were decreased at the time of ventilation transition and the end of ventilation treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05);the incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.043);the reintubation rate in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.023).Conclusion:PICW combined with SBT conversion standard is effective in mechanical ventilation of patients with respiratory failure,which can help patients recover blood gas index level,improve inflammatory factor level,reduce

关 键 词：呼吸衰竭 肺部感染控制窗 自主呼吸试验 有创机械通气 无创正压通气 

分 类 号：R563.8[医药卫生—呼吸系统]