PRVC通气模式治疗老年慢性阻塞性肺病致呼吸衰竭的临床疗效及其对肺气压伤的预防作用

目的分析研究PRVC通气模式在治疗老年慢性阻塞性肺病（COPD）引起的呼吸衰竭的临床疗效及其对肺气压伤的预防作用。方法选取我院46例老年COPD并呼吸衰竭患者,并将患者随机分为研究组（23例）和对照组（23例）。研究组采取PRVC通气模式,对照组的治疗方法是同步间歇指令通气（SIMV）,在通气治疗4 h及2 d后,分别观察两组生命体征、呼吸力学指标及动脉血气指标的变化。结果①生命体征：治疗4 h及2 d后,两组心率、血压等生命体征比较差异无统计学意义（P〉0.05）。②血气指标：治疗4 h后,研究组pH及PaCO2改善不如对照组明显,差异有统计学意义（P〈0.05）,其他血气指标组间比较差异无统计学意义（P〉0.05）;治疗2 d后两组各血气指标差异均无统计学意义（P〉0.05）。③呼吸力学指标：治疗4 h及2 d后,研究组呼气峰压均明显低于对照组,两组比较差异有统计学意义（P〈0.05）,两组其他呼吸力学指标比较差异均无统计学意义（P〉0.05）。结论采用PRVC通气模式对于治疗老年COPD致呼吸衰竭既能迅速有效地改善动脉血气分析又能确保吸气峰压维持在较低的范围,从而有效地降低气压伤出现的危险。

Clinical efficacy and lung crushed prevention of PRVC ventilation mode in the treatment of elderly COPD with respiratory failure

Objective To analyze the clinical efficacy of PRVC in the treatment of respiratory failure caused by elderly COPD and its preventive effect on pulmonary barotrauma.Methods 46 cases of elderly COPD patients suffered from respiratory failure,were randomly divided into study group(23 cases) and control group(23 cases).The study group was given PRVC ventilation treatment,the control group was given intermittent mandatory ventilation(SIMV),after 4 h and 2 d of treatment,vital signs,respiratory mechanics and arterial blood gas changes were observed.Results ①Vital signs: 4 h and 2 d after treatment,heart rate,blood pressure and other vital signs of the two groups were not significant(P > 0.05).② Blood gas analysis: after 4 h treatment,the pH and PaCO2 of the study group improve less obvious than that of control group,the difference was statistically significant between the two groups(P < 0.05),but the other blood gas between two groups was not significant(P > 0.05);2 d after treatment,blood gas of two groups were not significantly different(P > 0.05).③Respiratory mechanics: 4 h and 2 d after treatment,the peak expiratory pressure of study group was significantly lower than the control group,the difference was statistically significant(P < 0.05),the other respiratory mechanics index were not significantly different(P > 0.05).Conclusion PRVC ventilation mode for the treatment of elderly COPD with respiratory failure,can quickly and effectively improve arterial blood gas analysis while ensuring peak inspiratory pressure maintained in the lower range,thus effectively reduce the risk of barotrauma.