序贯机械通气联合尼可刹米治疗AECOPD合并Ⅱ型呼吸衰竭的临床观察

Clinical Effect of the Sequential Mechanical Ventilation Combined with Nikethamide in Treating AECOPD with Type 2 Respiratory Failure

目的:观察序贯机械通气联合尼可刹米在慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭中的的临床疗效及安全性。方法:按照随机原则将64例AECOPD合并Ⅱ型呼吸衰竭分成两组,对照组32例给予常规有创机械通气,治疗组患者给予序贯机械通气联合尼可刹米治疗,对两组治疗前、后24 h和48h的pH值、PaO2、PaCO2以及VAP、总机械通气时间、ICU时间,总住院时间,再插管率以及死亡率进行评价。结果:治疗组与对照组相比,pH值改善明显、PaO2明显增长、PaCO2下降显著,有统计学差异(P<0.05);治疗组ICU时间,总住院时间,再插管率以及死亡率与对照组相比,下降明显,有统计学差异(P<0.05)。结论:序贯机械通气联合尼可刹米治疗AECOPD合并Ⅱ型呼吸衰竭的临床疗效确切,值得临床推广。

Objective： To explore the clinical effect and safety of sequential mechanical ventilation combined with nikethamide in the treatment of the AECOPD with type 2 respiratory failure.Methods： 64 patients with AECOPD and type 2 respiratory failure were randomly divided into treating group（31 people） and control group（33 people）.The control group is performed with invasive mechanical ventilation,and the treating group is performed with sequential mechanical ventilation combined with nikethamide.To compare the arterial blood gas analysis,VAP,duration time of ventilation,the length of ICU,hospital staying time,reintubation rate and death rate between two groups.Results： Compared with the control group,the treating group had the pH improved,PaO2 increased and PaCO2 decreased significantly with statistical differences（P0.05）.The VAP,the length of ICU,hospital staying time,reintubation rate and death rate all declined as compared with the control group（P0.05）.Conclusion： The sequential mechanical ventilation combined with nikethamide had conclusive clinical efficacy in treating AECOPD with type 2 respiratory failure,and deserved promoting.