摘要
目的探讨有创及无创序贯通气治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的疗效。方法19例COPD患者无序贯治疗组,在达到“肺部感染控制窗”(Pulmonaryinfectioncontrolwindow,PIC)后即撤离有创通气,继之以无创通气;对照组为回顾性研究既往行常规机械通气治疗COPD合并呼吸衰竭患者20例,以SIMV+PSV方式至撤机,分别观察血气分析、胸片、通气时间、呼吸机相关性肺炎(VAP)、重新插管例数等指标。结果序贯治疗组有创通气时间、VAP等与对照组相比P<0.01,总机械通气时间、死亡率与对照组相比P<0.05,均有显著差异。结论序贯通气治疗COPD合并呼吸衰竭能明显缩短有创通气时间,减少重新插管和呼吸机相关肺炎,优于机械通气法。
Objective To evaluate the clinical effects of sequential noninvasive-invasive mechanical ventilation on COPD patients with respiratory failure. Methods Nineteen cases of COPD with respiratory failure were assigned in the treatment group using sequential noninvasive-invasive mechanical ventilation. When pulmonary infection was under control （the appearance of ＂PIC Window＂）, All patients in the group were extubated and received mask ventilation by non-invasive MV, The other control group （ n = 20） of COPD with respiratory failure continuously received MV after ＂PIC Window＂ appearance. Results The two groups had similar clinical characteristics and gas exchange. For the study and control groups, respectively, the durations of non-invasive MV was （6. 3 ± 2. 1 ） days and （ 18.2 ± 10. 3 ） days, the total durations of ventilator support were （ 13.4 ± 6.2 ） days and （ 18.2 ± 10. 3 ） days, the incidence VAP were 1/19 and 6/20 （ P 〈 0.01 ）, and the death rates were 1/19 and 3/20 （ P 〈 0. 05 ）. Conclusion In COPD patients with respiratory failure, early extubation followed by non-invasive MV initiated at the point of PIC Window may significantly decrease the invasive and total duration of ventilator support, the risk of VAP and the death rate.
出处
《临床肺科杂志》
2006年第4期445-446,共2页
Journal of Clinical Pulmonary Medicine
关键词
机械通气
慢性阻塞性肺疾病
呼吸衰竭
肺部感染控制窗
mechanical ventilation
chronic obstructive pulmonary disease
respiratory failure
pulmonary infection control
window
