序贯机械通气治疗老年重症肺炎的临床疗效观察

目的 探讨序贯机械通气治疗老年重症肺炎患者疗效及对肺泡氧合功能的影响。方法 选取2015年6月～2017年6月在北大医疗鲁中医院住院治疗需行机械通气治疗的老年SCAP患者102例，随机分为两组，各51例，行有创机械通气治疗为常规组，有创机械通气序贯无创机械通气治疗为序贯组，观察两组疗效及肺泡氧合功能。结果 序贯组的总机械通气时间及住院时间均显著少于常规组(P＜0.05)，其呼吸机相关性肺炎发生率(VAP)显著低于常规组(P＜0.05)，而两组的再次插管率及院内死亡率差异不显著(P＞0.05)；序贯组的PaO2及HCO3-浓度显著高于常规组(P＜0.05)。结论 序贯机械通气治疗用于老年重症肺炎患者，可有效缩减患者机械通气时间，降低其VAP发生情况，提高患者肺泡氧合功能，临床疗效显著。

Clinical Effect of Sequential Mechanical Ventilation on Elderly Patients with Severe Pneumonia

Abstract:Objective To investigate the effect of sequential mechanical ventilation on elderly patients with severe pneumonia and its effect on alveolar oxygenation function.Methods The patients who were hospitalized in Luzhong Hospital of Peking University from June 2015 to June 2017 were treated with mechanical ventilation.102 elderly patients with SCAP,the patients were randomly divided into two groups,51 cases in each group, treated with invasive mechanical ventilation as routine group and sequential non-invasive mechanical ventilation as sequential group.To observe the curative effect of the two groups and alveolar oxygenation.Results The total mechanical ventilation time of sequential group and hospitalization time were significantly less than the normal group(P<0.05),the incidence of ventilator-associated pneumonia(VAP)was significantly lower than normal group(P<0.05),while the reintubation rate and hospital mortality in the two groups no difference significant(P>0.05);PaO2 and HCO3-concentration in sequential group was significantly higher than that of the conventional group(P<0.05).Conclusion The sequential mechanical ventilation in elderly patients with severe pneumonia,which can effectively reduce the time of mechanical ventilation of patients,reduce the incidence of VAP, improve lung oxygenation function of patients with global,clinical curative effect is remarkable.