早期应用机械通气、优化抗菌方案对慢性阻塞性肺病合并重症肺部感染和呼吸衰竭治疗的评价

目的评价在慢性阻塞性肺病(COPD)合并重症肺部感染和呼吸衰竭的治疗中,早期应用机械通气(主要是使用无创人工通气)支持及配以优化的抗菌方案的临床意义。方法回顾43例COPD合并重症肺部感染和呼吸衰竭患者的两种不同的治疗方案,其中治疗1组(21例)采用一般氧疗及常规抗感染治疗,治疗2组(22例)以机械人工通气及优化的抗菌治疗方案,比较两种治疗方案的疗效。结果住院情况:两组病人的治愈好转率、未愈死亡率、住院日均有明显差异(P<0.05),住院费无显著差异(P>0.05)。血气分析指标:两组病人治疗后的血气对比,pH值无显著差异(P>0.05),PaO2有显著差异(P<0.01),PaCO2无显著差异(P>0.05)。结论对COPD合并重症肺部感染和呼吸衰竭患者,掌握时机,采用机械通气支持及选用优化的抗菌治疗方案,可以明显提高治愈好转率、降低死亡率,而且可以明显缩短患者的住院时间。

Estimating the therapeutic effect to chronic obstructive pulmonary disease with severe pulmonary infection and respiratory failure through performing mechanical ventilation in the early stage and optimalize the antibiosis therapy options

Objective Estimating the therapeutic effect to chronic obstructive pulmonary disease with severe pulmonary infection and respiratory failure thurough performing mechanical ventilation (mainly non-invasive mechanical ventilation) in the early stage, and optimalize the antibiosis therapy options. Methods Forty-three COPD patients with severe pulmonary infection and respiratory failure were involved in the study. They were randomly assigned to either group 1 (consisted of 21 patients ) or group 2 (consisted of 22 patients). Regular oxygen therapy and antibacterials were involved in group 1; mechanical ventilation and optimal antibiosis therapy option were involved in group 2. The therapeutic effect was compared between two groups. Results The cure rate, improvement rate, mortality rate, inefficiency, hospital days were significantly different between group1 and group 2 (P<0.05). There was no significantly difference between two groups in the cost of hospitalization. Comparing the blood gas analysis before and after the treatment in both groups: there was no significantly difference in pH and PaCO2 between two groups(P>0.05), PaO2 was significantly different between group 1 and group 2(P<0.01). Conclusion Performing mechanical ventilation in the early stage and optimalize the antibiosis therapy options to COPD patients with severe pulmonary infection and respiratory failure can increase the cure rate, decrease the mortality rate, and shorten the hospital days significantly.