有创与无创机械通气序贯疗法治疗慢性阻塞性肺疾病并发呼吸衰竭疗效观察

Comparison of sequential invasive-noninvasive mechanical ventilation in treatment of chronic obstructive pulmonary disease combined with respiratory failure

目的:探讨有创与无创机械通气序贯对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并呼吸衰竭患者疗效的影响。方法:将64例COPD并发呼吸衰竭患者随机分为2组,每组32例;在常规治疗的基础上,对照组采用有创机械通气治疗,治疗组采用有创与无创机械通气序贯疗法,比较2组患者治疗前后动脉血气、氧合指数,以及机械通气时间、住院时间、气管切开情况等。结果:2组患者治疗前后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数等指标均有明显改善(P<0.05)。2组撤机后总机械通气时间及住院时间比较差异有统计学意义(P<0.05),而气管切开、病死例数差异无统计学意义(P>0.05)。结论:有创与无创机械通气序贯疗法治疗COPD合并呼吸衰竭是一种有效的方法,值得临床推广应用。

Objective：To investigate the curative effect of sequential invasive-noninvasive mechanical ventilation on chronic obstructive pulmonary disease（COPD） combined with respiratory failure.Methods：Sixty-four cases of COPD with respiratory failure were randomly divided into two groups.On the basis of routine therapy,the patients in the control group were treated by the invasive mechanical ventilation and the treatment group by the sequential invasive-noninvasive mechanical ventilation.The arterial blood gas and the oxygenation index of the two groups were recorded before and after the therapy;the duration of mechanical ventilation,the length of hospitalization stay and the number of the cases receiving tracheotomy were compared.Results：The arterial oxygen pressure,the arterial carbon dioxide partial pressure and the oxygenation index of the two groups were significantly improved after treatment（P0.05）.After weaning,the total duration of mechanical ventilation and the length of hospital stay of the treatment group were much shorter than those of the control group（P0.05）;there was no statistical significance between the number of tracheotomy or mortality（P0.05）.Conclusions：Sequential invasive-noninvasive mechanical ventilation is an effective method for treatment of COPD combined with respiratory failure.It is worth popularizing.