改良气管食管双通导管应用机械通气抢救呼吸衰竭临床研究

Study of TDCC on mechanical ventilation in treatment of patients with respiratory failure

目的探讨改良气管食管双通导管应用机械通气抢救呼吸衰竭的临床意义。方法对44例因急性有机磷中毒、安眠成瘾类药中毒、乙醇、急性呼吸窘迫综合征(ARDS)或慢性阻塞性肺病(COPD)引起的II型呼衰等在病因的常规基础治疗上,病情加剧,呼吸衰竭,行气管插管、气管食管双通导管各22例,使用机械通气,模式包括同步间歇指令(SIMV)、压力支持(PSV)、呼吸末正压通气(PEEP),比较前后PH、PaO2、PaCO2、SaO2,进行用SPSS12.0统计学软件处理。参数均以均数±标准差(x±s)表示,前后及组间比较用t检验,组间率的比较用χ2检验,P<0.05为差异有统计学意义。结果气管食管双通导管组通气时间2￣13d,平均4.5d撤机,脱机成功率88.2%(19/22例),未能脱机而死亡2例(11.8%)。前后PH、PaO2、PaCO2、SaO2,P<0.05差异有统计学意义。结论应用气管食管双通导管行机械通气抢救呼衰的临床效果明显,基层医疗单位值得广泛应用。

Objective To study the values of TDCC on mechanical ventilation in treatment of patients with respiratory failure. Methods 44 cases with respiratory failure type U caused by organophosphorus pesticide poisoning.tranquilizers poisoning ,ethanolism ,ARDS or COPD,under the routine treatment,whose condition aggravated and got respiratory failure,then betook trachea cannula.22 cases betook TDCC and mechanical ventilation.The modes included synchronized intermittent mandatory ventilation（SIMV）,pressure support （PSV）,positive ondexpiratory pressure （PEEP）.Compared PH 、PaO2、PaCO2 and SaO2 after test and dealed with it by SPSS 12.0 statistics software.Parameter was showed by （-^x±s）.Used t-test to test comparison among groups. Used χ^2-test to test between-run imprecision.P〈0.05 was statistical meaning. Results Average mechanical ventilation days were 4.5 days （from 2 to 13 days）,19 of 22 patients had been succeeded in the weaning of mechanical ventilation . The overall mortality for all patients was 11.8%（2/22）. Conclusions TDCC a method mechanical ventilation in treatment of patients with respiratory failure is useful and should be recommended.