有创无创无隙通气在AECOPD合并Ⅱ型呼衰患者撤机时的应用效果分析

Application effect analysis of noninvasive ventilation in AECOPD with no gap withdrawal in patients with type 2 respiratory failure machine

目的分析有创无创无隙通气在慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼衰患者撤机时的应用效果。方法选取本院收治的52例AECOPD合并Ⅱ型呼吸衰竭患者作为研究对象,将其随机分为观察组与对照组,观察组26例进行有创无创无隙通气治疗,患者经有创通气过渡至无创通气之后进行撤机拔管,对照组26例患者进行常规有创通气治疗,患者经有创通气至撤机拔管,对两组患者撤机情况及呼吸机相关性肺炎(VAP)发生情况进行观察和比较。结果观察组患者的撤机成功率明显高于对照组,再插管与VAP发生率均明显低于对照组,两组比较差异有统计学意义(P<0.05)。观察组通气时间少于对照组,两组比较差异有统计学意义(P<0.05)。对照组患者在通气后120 min的HR、p H及Pa CO2等指标与拔管之前比较差异均无统计学意义(P>0.05)。结论 AECOPD合并Ⅱ型呼吸衰竭患者拔管之后立即进行有创无创无隙通气治疗可明显减少VAP发生率,同时可有效提高患者撤机成功率。

Objective To analyze the effect of application of non-invasive ventilation without gap in chronic obstructive pulmonary disease with acute exacerbation（AECOPD） combined with the withdrawal in patients with type 2 respiratory failure machine at. Methods Totally 52 cases of AECOPD admitted to our hospital with type 2 respiratory failure patients were selected as the research object. They were randomly divided into the observation group and contrast group. The observation group of 26 patients was given non-invasive ventilation in the treatment of patients with no gap, after transition to invasive ventilation noninvasive ventilation for weaning and extubation. Contrast group 26 patients were given conventional treatment in patients with invasive ventilation, invasive ventilation and weaning and extubation. Two groups of patients withdrawing machine and ventilator-associated pneumonia （VAP） were observed and compared the incidence of. Results The success rate of weaning was significantly higher than that of the contrast group in the observation group. Re intubation and the incidence of VAP in the observation group were significantly lower than that of the contrast group. The differences were statistically significant（ P 〈 0.05 ）. Ventilation time in the observation group was significantly less than the contrast group. The difference was statistically significant（ P 〈 0.05 ）. HR, pH and PaCO2 in patients with 120min index and pull in ventilation tube after than before there was no significant difference （ P 〈 0.05 ）. Conclusion AECOPD combined with pull in patients with type 2 respiratory failure tube immediately after noninvasive ventilation in the treatment of non gap could decrease the incidence of VAP significantly, and effectively improve the success rate of weaning patients, and has important clinical application value.