纤维支气管镜联合机械通气序贯治疗老年COPD严重呼吸衰竭的临床研究

目的：探讨纤维支气管镜联合机械通气序贯治疗老年COPD严重呼吸衰竭的临床效果。方法选择我科收治的116例老年COPD严重呼吸衰竭患者，随机分为纤维支气管镜联合机械通气序贯治疗组（简称观察组）以及单纯机械通气序贯治疗组（简称对照组），每组各58例。观察两组患者的临床疗效，机械通气治疗后的相关指标以及切换时间窗时的血气分析指标。结果观察组患者有效率84.48%，优于对照组有效率70.69%，差异具有统计学意义（P＜0.05）。与对照组比较，观察组的有创机械通气时间、总机械通气时间、呼吸衰竭纠正时间、感染控制窗出现时间、住院时间以及PaCO2均降低明显，PaO2和pH值则升高明显，差异具有统计学意义（P＜0.05）。结论纤维支气管镜联合机械通气序贯治疗老年COPD严重呼吸衰竭，可有效改善患者临床症状，缩短机械通气时间，提高疗效，具有临床推广价值。

Clinical analysis of treated with senile COPD severe respiratory failure by branchofiberoscope combined with sequential mechanical ventilation

Objective To discuss clinical effect of treated with senile COPD severe respiratory failure by branchofiberoscope combined with sequential mechanical ventilation.Methods Selected 116 cases senile COPD severe respiratory failure patients who were treated in our department,randomly divided them into branchofiberoscope combined with sequential mechanical ventilation treatment group （short for observation group） and simple sequential mechanical ventilation treatment group （short for control group）,58 cases in each group.Two group patients＇ clinical curative effects were observed.After treated by mechanical ventilation,relevant indexes and the index of blood gas analysis when switch time window were observed. Results Observation group patients＇ effective rate was 84.48%, better than control group＇s 70.69%,the differences had statistical significances （P〈0.05）.Compared with control group,observation group＇s invasive mechanical ventilation time,total mechanical ventilation time, correcting respiratory failure time, infection control window appear time,hospital length of stay and PaCO2 all obviously decreased,PaO2 and pH values all obviously increased,the differences had statistical significances（P〈0.05）. Conclusion Treated with senile COPD severe respiratory failure by branchofiberoscope combined with sequential mechanical ventilation can effectively improve patients＇ clinical symptoms, shorten mechanical ventilation time,improve therapeutic efficacy, have clinical extend value.