有创机械通气对COPD患者组织通气的影响

The study on effect of organizations ventilation in COPD patients with invasive mechanical ventilation

目的 探讨有创机械通气对慢性阻塞性肺疾病（COPD）患者组织通气的影响。方法以我院急诊科2009年1~12月应用有创通气的COPD患者42例为研究对象,比较分析患者有创机械通气前后氧合指数（PaO2/FiO2）、动脉血氧饱和度（SaO2）、动脉血二氧化碳分压（PaCO2）、血清酸碱度（pH）等指标的变化情况。结果 42例COPD患者经有创机械通气辅助呼吸治疗后,死亡3例,病死率为7.14%,其中肺部感染死亡2例,呼吸衰竭死亡1例。39例治疗有效,恢复有效通气,成功脱机。治疗时间5~37 d,平均18.36 d;39例治疗后PaO2/FiO2和SaO2指标显著高于治疗前（P〈0.01）,PaCO2和呼吸频率（RR）水平显著低于治疗前（P〈0.01）。结论对COPD患者应用有创机械通气可以通过增强组织通气,提高患者治疗效果,延长患者的生存时间,应在临床尝试推广。

Objective To investigate the effect of organizations ventilation in COPD patients with Invasive mechanical ventilation.Methods 42 cases of COPD in our hospital from January to December 2009 with invasive ventilation were enrolled in this study and analyze the change of the PaO2/FiO2,SaO2,PaCO2,PH and other indicators before and after invasive mechanical ventilation.Results In 42 cases of COPD with invasive mechanical ventilation therapy,3 died,the mortality rate was 7.14%,of which 2 cases died of pulmonary infection,1 case died of respiratory failure,and 39 were all treated effectively and successfully off-line,restoration of spontaneous breathing.Treatment time is 5～37 days,with average of 18.36 days;39 patients were treated off-line PaO2/FiO2,and SaO2 indices were significantly higher than before treatment（P0.01）;PaCO2 and RR was significantly lower than before treatment（P0.01）.Conclusion Application invasive mechanical ventilation in COPD patients can increase organizational efficiency,enhance patients′ outcomes and prolong the survival time of patients,it should be applied in clinical.