有创-无创机械通气序贯疗法在慢性阻塞性肺疾病急性加重期的应用

The application of invasive-non-invasive mechanical ventilation sequential therapy in acute exacerbation of chronic obstructive pulmonary disease

目的探讨有创-无创机械通气序贯疗法治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重期合并呼吸衰竭患者的疗效。方法将40例AECOPD并发呼吸衰竭患者随机分为观察组和对照组,每组各20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-无创机械通气序贯疗法,比较两组患者机械通气时间、住ICU时间、呼吸机相关性肺炎(VAP)、脱机失败率、病死率。结果观察组机械通气时间、住ICU时间、呼吸机相关性肺炎、脱机失败率均明显低于对照组,两者比较,差异有统计学意义(P<0.05);病死率差异无统计学意义(P>0.05)。结论有创-无创机械通气序贯疗法可明显缩短AECOPD患者机械通气时间和住ICU时间,降低VAP发生率和脱机失败率,疗效肯定。

Objective Investigate the curative effect of invasive -non-invasive mechanical ventilation sequential therapy in acute exacerbation of chronic obstructive pulmonary disease with respiratory failure （ chronic obstructive pulmonary disease , COPD ） .Methods 40 cases of AECOPD patients combined with respiratory failure were randomly divided into observation group and control group , 20 cases in each group .On the basis of conventional therapy , patients in control group were given invasive mechanical ventilation , however , patients in the observation group received invasive -non -invasive mechanical ventilation sequential therapy .Mechanical ventilation time, ICU staying time, ventilator associated pneumonia （VAP）, offline failure rate and mortality of the two groups were compared .Results The mechanical ventilation time , ICU staying time, VAP and offline failure rate of the observation group were significantly less than the control group , the differences between the two group were statistically significant （〈0.05）.There was no statistically significant difference in mortality （P〉0.05）.Conclusions The invasive -non -invasive mechanical ventilation sequential therapy can significantly shorten the mechanical ventilation time and ICU stay time of AECOPD , reduce VAP and offline failure rate , its curative effect is affirmed .