两种撤机方式在COPD病人中的应用比较

目的慢性阻塞性肺部疾患(COPD)病人在进行有创通气中常会遇到脱机困难,为解决此问题,寻找一种安全,快速的撤机方式。方法68例COPD并进行有创通气的病人,分T管组和双水平正压(BiPAP)组,每组各为34例,记录完全撤机时间,建立人工气道时间,呼吸机相关性肺炎(VAP)的发生率,3天的总体撤机成功率。结果BiPAP组相对于T管组具有较短的撤机时间和建立人工气道的时间,减少了VAP的发生率(P<0.01),短期和总体撤机成功率较高(P<0.05),将T管脱机失败的病人采用BiPAP序贯脱机,也能达到45%的成功率。结论COPD病人在撤机过程中采用BiPAP过渡,较传统T管法具有安全,快速,并发症少,节省费用的特点,值得临床推广。

Companson of two weaning mechanical ventilation modes in COPD patients

Objective To find out an safe an quick weaning mechanical ventilation (MV) mode in chronic obstructive pulmonary disease (COPD) patients. Methods 68 COPD patients after invasive MV divide into two groups.T tube group(34) and BiPAP group (34).And weaning MV time;artificial airway time;ventilation associate plumonary(VAP) rate;three day and all weaning MV rate. Results there are shorter weaning MV time,artificial airway time,three day and all weaning MV rate (P<0.05);and lower VAP rate(P<0.01).And so on ,there is up to 45% effiency rate in BiPAP patients who fail to weaning MV in T tube group.Conclusion Noninvasive BiPAP is an kind of safe quick and effective methods in weaning MV in COPD patients.It can be recommende for clinical use.