振动排痰机配合序贯机械通气治疗严重呼吸衰竭12例效果观察

Observation of the effectiveness of pumping sputum by sequential mechanical ventilation combined with vibrating sputum-ejection apparatus in the treatment of 12 cases of severe respiratory failure.

目的:探讨振动排痰机配合序贯机械通气治疗慢性阻塞性肺病(COPD)合并Ⅱ型呼吸衰竭患者的效果。方法:将接受气管插管和机械通气的12例COPD患者设为实验组,进行有创机械通气,出现肺部感染后拔除气管插管,改用经口鼻面罩无创机械通气,并给予振动排痰机叩击和振动,4次/d,直至脱机。选择同样病情患者12例作为对照组,出现肺部感染后,继续给予有创机械通气。结果:实验组与对照组有创机械通气的时间分别为6.0±2.3d和15.0±8.0d,两组比较有显著性差异(P<0.01)。结论:对COPD合并Ⅱ型呼吸衰竭患者行机械通气出现肺部感染时改用经口鼻面罩无创机械通气和振动排痰机治疗,可减少有创机械通气时间,减轻患者痛苦和护理工作负担。

Objective: To explore the effectiveness of pumping sputum by vibrating sputum-ejection apparatus combined with sequential mechanical ventilation in the treatment of COPD associated with type II respiratory failure.Methods: Invasive mechanical ventilation was conducted to 12 patients(taken as experiment group) with COPD and tracheal tube was not withdrawn until the occurrence of lung infection and non-invasive mechanical ventilation by mask was used instead.Meanwhile vibration was operated by vibrating sputum-ejection apparatus 4 times per day till withdrawing of the apparatus.The other 12 patients was chosen as control group and given continuous invasive mechanical ventilation even though lung infection occurred.Results: Significant difference was found in the comparison of the time of ventilation between the two groups(P<0.01).The time of invasive mechanical ventilation were respectively 6.0±2.3d and 15.0±8.0d in the experiment group and control group.Conclusion: Non-invasive mechanical ventilation by mask combined with vibrating sputum-ejection apparatus can shorten the time of invasive ventilation so that patient's suffering can effectively be relieved and nurse's burden can also be lightened.