机械通气治疗呼吸衰竭20例临床分析

目的总结分析机械通气治疗呼吸衰竭的经验和教训。方法回顾性收集2009年3月～2009年9月期间住院的呼吸衰竭患者的临床资料。结果 20例呼吸衰竭的病因中,AECOPD8例,重症肺炎6例,破伤风2例,重症哮喘、急性中毒、肠梗阻并急性呼吸窘迫综合征、耐药肺结核并感染各1例。有创机械通气模式为IPPV、IPPV＋PEEP、A/C或A/C＋PEEP,撤机模式为SIMV＋PSV,无创机械通气模式为PSV＋PEEP。成功撤机17例,死亡3例,治愈率达85%,死因为COPD并DIC、呼吸机相关肺炎、侵袭性肺曲霉菌感染和病原体未明性重症肺炎。结论机械通气是治疗呼吸衰竭的有效措施,预防机械通气相关并发症、有效的抗感染等综合治疗是提高呼吸衰竭抢救成功率的关键。

Clinical analysis of 20 cases suffered from respiratory failure by mechanical ventilation treatment

Objective To summarize the experience and lesson of mechanical ventilation in the treatment of respiratory failure.Methods Clinical data of the inpatients being suffered from respiratory failure were collected from March 2009 to September 2009.Results 20 cases were diagnosed as respiratory failure,of them 8 cases were resulted from acute exacerbation of chronic obstructive pulmonary disease,6 cases were suffered from severe pneumonia,2 cases were suffered from tetanus,1 case of respiratory failure was resulted from acute poisoning,acute respiratory distressed syndrome by instestinal obstruction,drug-resistant pulmonary tuberculosis complicating lung infection,or severe bronchial asthma,respectively.The IPPV,IPPV＋PEEP,A/C,A/C＋PEEP mode was used as the invasive positive pressure ventilation mode.Noninvasive positive pressure ventilation mode was used as PSV and PEEP.The weaning mode was used by SIMV＋PSV.17 cases were successfully weaned.3 cases died,the cure rate was 85%.The causes of death were COPD complicating disseminated intravascular coagulation,ventilation-associated pneumonia,invasive pulmonary aspergillosis,or unknown pathogen infection-associated severe pneumonia.Conclusion Mechanical ventilation is regarded as an effective measurement in the treatment of respiratory failure.It plays a role in the improvement of cure rate for the respiratory failure by effective anti-infection or preventing from complications associated with mechanical ventilation.