应用无创和有创机械通气治疗肺性脑病的临床疗效分析

Clinical efficacy analysis of noninvasive mechanical ventilation versus invasive mechanical ventilation to treat pulmonary encephalopathy in chronic obstructive pulmonary disease

目的分析无创机械通气和有创机械通气治疗慢性阻塞性肺疾病(COPD)并发肺性脑病的疗效。方法回顾性分析西安医学院第一附属医院呼吸内科2010年1月至2011年6月收治的COPD合并肺性脑病患者的临床资料,选取采用机械通气治疗的患者,根据机械通气的方式不同分为无创组和有创组,分析两组的治疗效果。结果两组治疗后在血气分析上均明显改善,但有效率和病死率比较差异无统计学意义,同时无创组的并发症明显低于有创组。结论对COPD合并肺性脑病的患者治疗上首选机械通气治疗,并且无创机械通气并不是绝对禁忌证,值得推广。

Objective To analyze the effect of noninvasive mechanical ventilation versus invasive mechanical ventilation on patients with COPD combined with pulmonary encephalopaphy. Methods The clinical data of patients with pulmonary encepha- lopaphy due to COPD treated by mechanical ventilation in the department of respiratory medicine between January 2010 and June 2011 were retrospectively analyzed. According to the different way of mechanical ventilation, these patients were divided into two groups,the noninvasive group and the invasive group. And the outcomes of the two groups were analyzed and compared. Results ABG was significantly improved in both groups after mechanical ventilation. The effective rates and mortality were simi- lar in the two groups. But the complications of noninvasive group were less than those of invasive group. Conclusion Mechanical ventilaton is the first choice for the treatment of COPD with hypercapnic encephalopaphy, and noninvasive mechanical ventilation is not the absolute contraindication and it is worthy of clinical application.