序贯机械通气治疗慢性阻塞性肺疾病伴呼吸衰竭的疗效评价

目的 探讨序贯机械通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效.方法 2012年2月至2013年12月期间,我院诊治的60例慢性阻塞性肺疾病合并呼吸衰竭患者,随机将其分为对照组（有创机械通气治疗）和观察组（有创-无创序贯机械通气治疗）,每组30例,对两组治疗前后心肺功能（HR、RR、FEV1％、FEV1/FVC）、血气指标（PaO2、PaCO2、SaO2）以及再插管率和VAP发生率,进行观察和比较.结果 与治疗前相比,治疗后两组心肺功能和血气指标均有明显改善,差异有统计学意义（P＜0.05）;与对照组相比,治疗后观察组心肺功能和血气指标均有明显改善,再插管率和VAP发生率均显著降低,差异有统计学意义（P＜0.05）.结论 对于慢性阻塞性肺疾病合并呼吸衰竭患者,有创-无创序贯机械通气治疗的疗效显著,明显改善患者的心肺功能和血气指标,降低再次插管和VAP发生率,值得临床推广.

The efficacy evaluation of sequential mechanical ventilation in the treatment of chronic obstructive pulmonary disease combined with respiratory failure

Objective To study the clinical efficacy of sequential mechanical ventilation in the treatment of chronic obstructive pulmonary disease combined with respiratory failure. Methods 60 cases of chronic obstructive pulmonary disease combined with respiratory failure in our hospital from Feb 2012 to Dee 2013 were randomly divided into control group （invasive mechanical ventilation treatment） and observation group （invasive and noninvasive sequential mechanical ventilation treatment）, 30 cases in each group. The cardiopulmonary function （HR, RR, FEVI%, FEV1/FVC）, blood gas indexes （PaO2, PaCO2, SaO2） before and after treatment, and the incidence of re-intubation and VAP in two groups were compared. Results Compared to pre-treatment, the cardiopulmonary function and blood gas indexes significantly improved on post-treatment in both two groups, with statistically significant differences （P 〈 0.05）. Compared to control group, the cardiopulmonary function and blood gas indexes on post-treatment in observation group significantly improved, and the incidences of re-intuhation and VAP were obviously lower, with statistically significant differences （P 〈 0.05）. Conclusions Invasive and noninvasive sequential mechanical ventilation has a significant efficacy in the treatment of chronic obstructive pulmonary disease combined with respiratory failure, which can obviously improve patients＇ cardiopulmonary function and blood gas indexes, reduce the incidence of re-intubation and VAP, worthy of clinical promotion.