肺大疱患者呼吸衰竭时的机械通气治疗

目的：比较2种潮气量水平机械通气治疗肺大疱患者发生呼吸衰竭时的疗效及安全性。方法：63例发生呼吸衰竭的肺大疱患者随机分为小潮气量组（L组）和常规潮气量组（O组）,给予气管插管接呼吸机通气,分别采用小潮气量联合低水平呼气末正压（PEEP）通气和常规潮气量联合低水平PEEP通气,比较2组呼吸衰竭改善情况、气压伤发生情况。结果：治疗后2组患者全身症状改善明显,血气主要指标pH值、PaO2、PaCO2较治疗前明显改善（P〈0.05）;2组间比较,除PaCO2外,其余血气指标差异无显著性。L组仅1例患者发生气胸,O组有9例患者发生气胸,差异有显著性（P〈0.05）。结论：小潮气量联合低水平PEEP机械通气治疗肺大疱患者发生呼吸衰竭疗效肯定,可以减少气胸等并发症,值得临床推广应用。

Mechanical Ventilation for Pulmonary Bulla Patients With Respiratory Failure

Objective：To compare the clinical effects and safety of low tidal volume and ordinary tidal volume mechanical ventilation for pulmonary bulla patients with respiratory failure.Methods：Sixty-three pulmonary bulla patients with respiratory failure were divided into low tidal volume group（group L） and ordinary tidal volume group（group O）,both patients were given tracheal intubation.The therapeutic effects and complications were compared between the two groups.Results：The symptoms and blood gas analysis were improved in two groups and the incidence of pneumothorax in group L was significantly lower than that in group O（P0.05）.Conclusions：Low tidal volume combined with low level PEEP mechanical ventilation is an effective method for pulmonary bulla patients with respiratory failure.It could reduce lung injury caused by ventilator,and was worth to recommend for clinical application.