序贯性机械通气抢救非COPD病因所致严重呼吸衰竭

目的探讨有创与无创序贯机械通气（简称序贯性机械通气）抢救非COPD病因所致严重呼吸衰竭的临床效果及应用价值。方法选择非COPD病因所致呼吸衰竭患者18例为非COPD组，COPD所致呼吸衰竭15例为COPD组。先经口气管插管正压通气，根据病情在3—7天内拔除气管插管改为无创正压通气。观察两组病例的血气分析指标、机械通气时间、呼吸机相关性肺炎发生例数、撤机成功例数、住院死亡例数等。结果非COPD组和COPD组治疗前基础情况匹配良好（P均〉0．05）。非COPD组有刨通气时间明显长于COPD组（P〈0．05），总通气时间、撤机成功例数、住院死亡例数两组均无显著性差异（P〉0．05），住院费用明显高于COPD组（P〈0．05）。结论序贯性机械通气策略对非COPD病因所致呼吸衰竭可能也具有一定优势。

Application of sequential invasive to noninvasive mechanical ventilation in treatment of severe respiratory failure due to non-COPD

Objective To evaluate the efficacy of early extubation and sequential invasive to noninvasive mechanical ventilation(MV) in treatment of severe respiratory failure due to non-COPD.Methods 18 patients with severe respiratory failure due to non-COPD were involved in the non-COPD group.15 cases with severe respiratory failure from COPD were assigned to COPD group.After 3~7 days intubation and invasive positive pressure MV,the extubation was conducted and followed by noninvasive MV.The markers of blood gas anal...