序贯机械通气治疗COPD呼吸衰竭的临床研究

目的研究序贯机械通气治疗COPD呼吸衰竭的临床应用前景。方法将慢性阻塞性肺疾病合并呼吸衰竭患者55例,给予抗感染和平喘等治疗;采用气管插管进行有创机械通气。待"肺感染控制窗"出现后随机分为两组,其中治疗组22例,对照组33例,治疗组拔除气管导管,改用无创正压通气;对照组继续有创机械通气,以(SIMV+PSV)方式分别减少到7～9次/min和5～8cmH2O水平时直至脱机。比较两者患者总机械通气时间、总住院时间及呼吸机相关性肺炎发生率。结果序贯治疗组与对照组的总机械通气时间(11.33±2.62)dvs(13.91±4.52)d,P<0.01],总住院时间(18.63±3.62)dvs(21.20±6.42)d,P<0.05],呼吸机相关性肺炎发生率5.86%vs28%,P<0.01]不同,差异均有统计学意义。结论采用序贯机械通气治疗COPD呼吸衰竭较传统的有创通气方式更优越,能够有效缩短总通气时间和住院时间,降低呼吸机相关性肺炎发生率。

The clinical research of sequential mechanical entilation COPD respiratory failure

Objective to study the sequential mechanical entilation COPD respiratory failure of clinical application. Methods Chronic obstructive pulmonary disease combination of respiratory failure patients 55 pa- tients, were given fight infection peace wheezing. The tracheal intubation for and mechanical ventilation. Stay ＂lung infection control window＂ appears after randomly divided into two groups, including 22 cases in treatment group and control group in 33 cases, the treatment group pull out the endotracheal tube, convert noninvasive posi- tive pressure ventilation. The control group will continue to have and mechanical ventilation to （ SIMV ten PSV） way to reduce to 7-9 respectively times/rain and 5 N 8 when cmH20 level until offline. Compared with the total mechanical ventilation time, total hospital stay and breathing machine correlation between incidence of pneumoni- a. Results The sequential treatment group and control group total mechanical ventilation of time （ 11.33 ＋ /- 2. 62 days vs 13.91 ＋ /-4. 52 days, P 〈 0. 01 ], total hospital stay （ 18.63 ＋ /-3.62 days vs 21.20 ＋ /-6. 42 days, P 〈 0. 05], the ventilator correlation 5. 86% vs 28% incidence of pneumonia, P 〈 0. 01 ] different, are statistically significant differences. Conclusion The sequential mechanical entilation COPD respiratory failure and the ventilation than the traditional way more superior, can shorten the time and total ventilation hospitalization time and lower respiratory machine correlation between incidence of pneumonia.