有创与无创通气治疗慢性阻塞性肺疾病并呼吸衰竭疗效分析

Analysis of clinical effect nvasive and non-invasive ventilation in the treatment of respiratory failure of chronic obstructive pulmonary disease

目的分析有创与无创通气在慢性阻塞性肺疾病并呼吸衰竭治疗中的效果。方法COPD并呼吸衰竭使用机械辅助通气的患者108例,无创(FMMV)组62例,有创(ETMV)组46例,比较两组患者治疗前后的动脉血气变化及疗效相关指标。结果机械通气4h后,ETMV组的PH、PaCO2、PaO2均明显改善(P<0.05),FMMV组仅PaO2明显改善(P<0.05),PH、PaCO212h后才出现明显改善(P<0.05)。ETMV组的机械通气时间短于FMMV组(t=2.086,P<0.05),两组总住院时间及治疗成功率无明显差别(P>0.05)。结论在治疗COPD并呼吸衰竭时,ETMV能更快地改善血气指标,机械通气时间短于FMMV;FMMV可使部分患者避免气管插管;两种方法治疗的患者在总住院时间、治疗成功率方面无明显差别。

Objective To analyze the clinical effect of invasive and non-invasive ventilation on respiratory failure in patients with chronic obstructive pulmonary disease. Methods 108 patients in our hospital were enrolled. There were two groups： face mask mechanical ventilation （ FMMV group, n = 62） and endotracheal intubation mechanical ventilation （ ETMV group, n = 46）. Results After 4 hours of mechanical ventilation, PH, PaCO2, PaO2 significantly improved in the ETMV group （P 〈 0. 05 ）. However, in the FMMV group, only PaO2 was significantly improved （P 〈 0. 05 ）. Measures of PH, PaCO2 were significantly improved after 12 h （ P 〈 0. 05 ）. The duration of mechanical ventilation was shorter in the ETMV group （ t = 2. 086, P 〈 0. 05 ） ; There were no significant differences in the days in hospital and effective rate between these two groups （ P 〉 0. 05 ）. Conclusion ETMV can improve the arterial blood gas of respiratory failure in patients with COPD quickly and shorten the duration of mechanical ventilation. Some patients can avoid the use of intubation through FMMV. As for the hospital stay, mortality in hospital and effective rate, there are no significant differences between ETMV and FMMV groups.