有创-无创序贯通气疗法治疗慢性阻塞性肺疾病 引发的严重呼吸衰竭的临床研究

目的 对照研究以肺部感染控制窗为切换点行有创与无创序贯机械通气治疗慢性阻塞性肺疾病所致严重呼吸衰竭的临床疗效。方法 选取2017年2月~2018年2月在我院诊治的130例慢性阻塞性肺疾病所致严重呼吸衰竭患者为研究对象，依据随机数字表法分为对照组和观察组，各65例，对照组采用常规有创通气治疗，观察组采用有创-无创序贯通气治疗，观察对比两组并发症发生率、通气时间等指标。结果 观察组动脉血氧饱和度、二氧化碳分压、动脉血氧分压、动脉血气指标与对照组对比，差异无统计学意义（P＞0.05）；观察组有创通气时间短于对照组，呼吸机相关肺炎发生率低于对照组，ICU入住时间短于对照组，病死率低于对照组，差异有统计学意义（P＜0.05）。结论 以PIC窗为切换点采用有创与无创序贯机械通气治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭，可缩短有创通气时间，显著改善动脉血气指标，降低病死率。

Clinical Study of Invasive Non-invasive Sequential Ventilation in Treatment of Severe Respiratory Failure Caused by Chronic Obstructive Pulmonary Disease

Abstract:Objective To compare the clinical efficacy of sequential invasive and non-invasive mechanical ventilation in the treatment of severe respiratory failure caused by chronic obstructive pulmonary disease with the control window of pulmonary infection as the switching point.Methods A total of 130 patients with severe respiratory failure caused by chronic obstructive pulmonary disease who were treated in our hospital from February 2017 to February 2018 were selected and divided into a control group and an observation group according to the random number table method.Each group had 65 patients.The control group was treated with conventional invasive ventilation.The observation group was treated with invasive-noninvasive ventilation gas.The incidence of complications and ventilation time were compared between the two groups.Results There was no significant difference in arterial blood oxygen saturation,partial pressure of carbon dioxide,arterial blood oxygen pressure and arterial blood gas between the observation group and the control group,the difference was not statistically significant(P>0.05);the time of invasive ventilation in the observation group was shorter than that of the control group,the incidence of ventilator related pneumonia was lower than that of the control group,and the time for ICU to stay was shorter than the control group,and the mortality rate was lower than the control group,the difference was statistically significant(P<0.05).Conclusion The use of invasive and non-invasive sequential mechanical ventilation for the treatment of acute exacerbation of chronic obstructive pulmonary disease with respiratory failure using the PIC window as the switching point can shorten invasive ventilation time,significantly improve arterial blood gas index,and reduce mortality.