机械通气在AECOPD患者治疗中的临床观察

Clinical observation of the COPD patients during the acute aggravated period

目的观察机械通气在慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗中的应用,进一步探讨机械通气的应用价值。方法观察30例AECOPD患者应用无创或有创机械通气治疗效果,比较机械通气治疗前后动脉血气分析指标和呼吸机参数的变化及其临床意义。结果30例AECOPD患者经机械通气治疗后各项呼吸机参数指标较治疗前均有不同程度的好转,动脉血气分析指标明显好转。无创及有创机械通气治疗后呼吸频率(RR)、呼出潮气量(EVT)、分钟通气量(MV)、平均气道压(MAP)、呼气末正压(PEEP)、压力支持(PS)、吸入氧浓度(FiO2)以及动脉血气分析指标(PH、PaO2、PaCO2)与治疗前比较均有显著性差异(P<0.01)。结论机械通气在治疗AECOPD患者过程中,有助于改善呼吸肌疲劳,克服气道阻力,降低肺顺应性,从而使呼吸机各项参数及动脉血气分析指标得到改善。

Objective To observe the patients of the chronic obstructive pulmonary disease（COPD） in the acute aggravated period by mechanical ventilation in order to explore its effect and significance. Methods Noninvasive or invasive mechanical ventilation （ CPAP or SIMV mode） was used to treat 30 COPD patients in the acute aggravated period, and the changes of the blood gas analysis and respiratory parameters were compared before and after the treatments. Results There were obvious changes in respiratory parameters and blood gas analysis before and after the treatments. With the treatments of the noninvasive or invasive mechanical ventilation, there were significant difference between before and after the treatments in the measures of respiratory rate （RR）, expired title volume （EVT）, minute ventilation （MV）, mean airway pressure （MAP）, positive end-expiratory pressure （PEEP）, pressure support ventilation （PSV）, flow of inhale oxygen （ FiO2 ） and blood gas analyses （ PH, PaO2, PaCO2 ）. Conclusion Using noninvasive and invasive mechanical ventilation to treat COPD patients in the acute aggravated period can help COPD patients improve the function of their respiratory muscle, re- duce airway resistance and lung compliance, and improve the respiratory parameters and blood gas analysis.