序贯有创-无创机械通气治疗AECOPD合并Ⅱ型呼吸衰竭患者临床价值探讨

Sequential Invasive-non-invasive Mechanical Ventilation in the Treatment of Clinical Value AECOPD Patients with Respiratory Failure Combined with TypeⅡ

目的:探究序贯有创-无创机械通气治疗AECOPD合并Ⅱ型呼吸衰竭患者临床价值。方法:选取2010年6月-2012年6月我院收治的AECOPD合并Ⅱ型呼吸衰竭患者60例,将其随机分成观察组30例与对照组30例,在常规治疗基础上分别行序贯机械通气与常规有创机械通气治疗,分析比较两组治疗前、后动脉血气指标与主要的通气指标等情况。结果:观察组治疗24h后动脉血pH值、PaCO2及PaO2与治疗前和对照组拔管时比较有明显改善,具有显著差异(P<0.05);观察组有创通气时间明显减少,呼吸机相关性肺炎(VAP)发生率与再插管率显著下降,两组结果比较具有显著差异(P<0.05)。结论:序贯有创-无创机械通气治疗AECOPD合并Ⅱ型呼吸衰竭的疗效确切,可改善呼吸肌劳损,降低再插管率与VAP发生率,减少ICU住院时间,并能够明显提高呼吸功能,安全可靠,值得临床推广与应用。

Objective： To explore clinical value for the sequential invasive-non-invasive mechanical ventilation in patients with AECOPD of combined type Ⅱ respiratory failure. Methods： Our hospital form June 2010 to June 2012 were treated 60 cases of AECOPD with type Ⅱ respiratory failure patients were randomly divided into observation group of 30 patients with 30 cases in the control group,respectively, in the conventional therapy routine has sequential invasive mechanical ventilation and mechanical ventilation , analysis and comparison of the two groups before and after treatment with the main indicators of arterial blood gas ventilation index and so on. Results：The arterial blood pH, PaCO2 and PaO2 before the treatment and control groups with a significant improvement, with a significant difference （P〈 0. 05）;observation group had significantly reduced invasive ventilation, ventilator-associated pneumonia （VAP） incidence and re-intubation rate was significantly decreased in both groups had significant differences in the results of comparison （P〈0. 05 ）. Conclusion： Sequential invasive-non-invasive mechanical ventilation treatment efficacy combined AECOPD exact type Ⅱ respiratory failure, improve respiratory muscle fatigue, lower reintubation rate and the incidence of VAP, reduce ICU length of stay, and can significantly improve respiratory function, safe and reliable worthy of promotion and application.