序贯机械通气治疗COPD呼吸衰竭疗效观察

The Effect of Clinical Study In Agencied COPD Insulting Severe Respiratory Failure By Using Sequential Invasive And Non-invasive Mechanical Ventilation

目的:探讨有创-无创序贯机械通气治疗慢性阻塞性肺疾病(COPD)合并严重呼吸衰竭的临床疗效。方法:随机选取25例COPD急性期合并严重呼吸衰竭患者予有创后脱机拔除气管插管序贯无创机械通气治疗,23例采用传统有创机械通气治疗,记录并分析比较两组间患者治疗初基础情况和在有创机械通气时间、住重症监护病房时间、总的机械通气时间、总住院时间,及呼吸机相关性肺炎(VAP)发生率、再插管率等。结果:序贯机械通气治疗COPD急性期合并呼吸衰竭疗效显著,有创通气时间、住呼吸重症监护病房时间、总住院时间序贯组较传统组均缩短P<0.05,VAP发生率、再插管率均低于传统组P<0.05。结论:在患者支气管-肺部感染控制好转,痰液性状改善情况下停有创,序贯无创治疗具有优越性。

Objective ：To evaluate the clinical effect of sequential invasive and non - invaslve mechanical ventilation on COPD patient with severe respiratory failure. Methods： select randomly 25 patients with ageneied COPD insulting severe respiratory failure underwent sequential invasivc and non - invasire mechanical ventilation, 23 patients underwent conventional invasive mechanical ventilation treatment, record and analyze and compare the basics of patients before treatment and the invasivc mechanical ventilation time, the stayed RICU time, total mechanical ventilation time, total length of stay in hospital time ; and the incidence of ventilator associated pneumonia （VAP）, in- cidence of repeated tracheal intubation. Results： sequential inva- sire and non - invasive mechanical ventilation in ageneied COPD insulting severe respiratory failure had significant therapeutic effect,the invasive mechanical ventilation time, the stayed RICU time and total length of stay in hospital time shorted（ P 〈 0. 05 ） ; and the incidence of ventilator associated pneumonia （VAP） , incidence of repeated tracheal intubation in sequential invasive and non - invasive mechanical ventilation was lower than conventional treatment （ P 〈 0. 05 ）. Conclusion ： after infection of the bronchia and lung were controlled, and the character of phlegm had improved, sequential invasive and non - invasive mechanical ventilation had superiority.