有创机械通气在抢救慢性阻塞性肺疾病急性加重期的临床研究

目的观察有创机械通气治疗慢性阻塞性肺疾病急性加重期的疗效，探讨其临床应用的价值。方法对我院收治的67例慢性阻塞性肺痰病急性加重期患者采用经口（鼻）气管插管及机械通气治疗，观察机械通气前后2hRR、HR、SBP、DBP、SaO2和动脉血气分析指标pH、PaO2、PaCO2以及患者临床症状等的变化。结果67例慢性阻塞性肺疾病患者应用机械通气治疗2h后，56例患者临床症状明显缓解，呼吸困难好转，口唇发绀及肺啰音明显改善，动脉血气分析指标pH、PaO2、PaCO2以及监测指标RR、HR、SaO2均有显著改善（P〈0．01），SBP、DBP差异有统计学意义（P〈0．05），患者病情好转并出院，成功率达83．58％；因肺部感染加重和多器官衰竭死亡6例（8．96％），因病情危重放弃抢救5例（7．46％）。结论熟练掌握慢性阻塞性肺疾病急性加重期机械通气治疗技术，对提高抢救成功率起非常重要的作用。

Clinical research on the invasive mechanical ventilation in rescuing patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To observe the therapeutic effect of invasive mechanical ventilation in rescuing patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）and discuss its clinical value. Methods 67 patients with AECOPD in our hospital were treated with endotracheal intubation through mouth （nose） and mechanical ventilation. The change of 2h RR, HR, SBP, DBP, SaO2,arterial blood gas analysis （pH, PaO2, PaCO2 ） and patients clinical symptoms before and after mechanical ventilation were observed. Results After applying mechanical ventilation to 67 patients with AECOPD, pH, PaO2, PaCO2, RR, HR, SBP, DBP, SaO2 were improved significantly （P〈0.05 or 0. 01） and clinical symptoms including dyspnea , cyanosis of lips, lung rales were remarkable improved either among 56 cases（83.58%）. 6 cases （8.96%）died of aggravated pulmonary infection and multiple organ failure . 5 cases （7. 46%） were given up the treatment because the critical conditions. Conclusion Mastering the mechanical ventilation therapy technique for AECOPD is important to increasing its success rate of rescue.