有创-无创序贯机械通气治慢性阻塞性肺疾病合并呼吸衰竭患者疗效

摘要

Objective:To observe the therapeutic effect of sequential mechanical ventilation in the treatment of COPD patients with respiratory failure. Methods:In 2010 February to 2010 December in our hospital 76 patients received treatment of COPD complicated with respiratory failure as the object, and were randomly divided into 2 groups. The control group underwent invasive positive pressure ventilation in the treatment, treatment group was treated with sequential mechanical ventilation. The two groups were observed in patients with mechanical ventilation time, hospitalization time, the rate of successful weaning, VAP occurrence rate index. Results:The treatment group and the control group the incidence of VAP were 7.89%and 26.31%, the success rate is respectively 94.73%and 78.94%, the mechanical ventilation time were (11.01 ± 3.71) D and (14.77 ± 3.53) d, total hospitalization time were (17.50 ± 3.67) D and (20.32 ± 4.15) d, the differences between the 2 the index of group P<0.05 had statistical significance. Conclusion:Sequential mechanical ventilation in the treatment, can significantly reduce ventilation time, shorten the hospitalization time, improve the success rate of weaning, decrease the incidence of VAP patients, improve the success rate of rescue.%目的：观察应用有创-无创序贯机械通气方法治疗COPD合并呼吸衰竭患者的疗效。方法：以2010年2月至2010年12月在我院接受治疗的慢性阻塞性肺疾病(COPD)合并呼吸衰竭76例患者为研究对象，随机分为2组。对照组行有创正压通气治疗，治疗组行有创机械通气达到切换点拔管后继续行无创序贯通气治疗。观察两组患者机械通气时间、住院时间、脱机成功率、呼吸机相关性肺炎(VAP)发生率等指标。结果：治疗组与对照组的VAP发生率分别是3例（7.89%）和10例（26.31%），脱机成功率分别是36（94.73%）和30（78.94%），机械通气时间分别是（11.01±3.71）d和(14.77±3.53)d，总住院时间分别是（17.50±3.67）d和（20.32±4.15）d，2组各项指标差异有统计学意义P<0.05。结论：在PIC窗指导下有创-无创序贯通气治疗，能显著减少通气时间，缩短住院时间，提高脱机成功率，降低VAP发生率，提高患者抢救成功率。