经口有创-无创序贯性机械通气在抢救高龄重症呼吸衰竭患者中的价值

The Value of Oral Invasive-noninvasive Sequential Mechanical Ventilation in the Rescue of Senile Patients with Severe Respiratory Failure

目的探讨经口有创-无创序贯性机械通气在抢救高龄重症呼吸衰竭患者中的价值。方法选择2019年5月至2020年1月我院收治的高龄重症呼吸衰竭患者80例,采用随机数字表法将其分为观察组(n=40)和对照组(n=40)。在对症治疗基础上,观察组给予经口有创-无创序贯性机械通气治疗,对照组给予机械通气治疗。比较两组通气质量指标、动脉血气指标及并发症、病死率及脱机成功率。结果观察组有创机械通气(IMV)时间、总机械通气时间和ICU住院时间均较对照组短,差异有统计学意义(P<0.05);与对照组相比,观察组PaO2水平较高,PaCO2水平较低,差异有统计学意义(P<0.05);观察组呼吸机相关性肺炎(VAP)发生率低于对照组,观察组脱机成功率高于对照组,差异有统计学意义(P<0.05);两组病死率比较,差异不显著(P>0.05)。结论高龄重症呼吸衰竭患者经口有创-无创序贯性机械通气治疗,可改善动脉血气指标,缩短通气时间及ICU住院时间,且并发症少,脱机成功率高,利于患者预后。

Objective This paper aims to investigate the value of oral invasive-noninvasive sequential mechanical ventilation in the rescue of senile patients with severe respiratory failure.Methods 80 senile patients with severe respiratory failure who admitted in the hospital from May 2019 to January 2020 were divided into observation group(n=40)and control group(n=40)according to random number table.On the basis of symptomatic treatment,observation group was given oral invasive-noninvasive sequential mechanical ventilation,and control group was treated with mechanical ventilation.The ventilation quality indexes,arterial blood gas indexes,complications,case fatality rate and weaning success rate were compared between two groups.Results The IMV time,total mechanical ventilation time and ICU stays in observation group were shorter than those in control group(P<0.05);Compared with control group,the level of PaO2 in observation group was higher,and the level of PaCO2 in observation group was lower(P<0.05);The incidence of VAP in observation group was lower than that in control group,and the weaning success rate in observation group was higher than that in control group(P<0.05);There was no statistical difference in the case fatality rate between two groups(P>0.05).Conclusion Oral invasive-noninvasive sequential mechanical ventilation in senile patients with severe respiratory failure can improve arterial blood gas indexes,shorten ventilation time and ICU stays,have less complications and high weaning success rate,and promote the prognosis.