有创和无创序贯机械通气治疗肺结核并严重呼吸衰竭的临床疗效对比

Comparison of clinical effect of invasive and non-invasive sequential mechanical ventilation in treatment of pulmonary tuberculosis and severe respiratory failure

目的探讨有创和无创序贯机械通气治疗肺结核并严重呼吸衰竭的临床疗效。方法选择我院2014年1月至2016年1月收治的46例肺结核并严重呼吸衰竭患者实施有创机械通气,当肺部感染基本控制时,随机分为两组,每组23例。对照组患者继续行同步间歇指令通气加压力支持通气,观察组患者改无创序贯机械通气治疗。观察两组患者治疗效果,并就两组患者脱机时间进行对比。结果观察组和对照组患者治疗总有效率分别为95.65%、69.57%,两组比较差异有统计学意义(P<0.05)。观察组患者脱机时间(4.2±1.2)d显著低于对照组(5.8±1.4)d,差异有统计学意义(P<0.05)。结论肺结核并严重呼吸衰竭实施有创机械通气,当肺部感染基本控制时,改无创序贯机械通气可以缩短机械通气时间,临床疗效较好,值得临床推广。

Objective To probe into the clinical effects of invasive and non-invasive sequential mechanical ventilation in the treatment of pulmonary tuberculosis and severe respiratory failure. Methods 46 patients with pulmonary tuberculosis and severe respiratory failure and who performed invasive mechanical ventilation in our hospital from January,2014 to January,2016 were selected,when the lung infection control were controlled,and were randomly divided into two groups,23 cases in each group. In the control group,patients were treated with intermittent mandatory ventilation and pressure support ventilation while in the observation group,patients were treated with noninvasive sequential mechanical ventilation. Then,the treatment effect of two groups of patients was observed,and the offline times of two groups of patients were compared.Results The total effective rate in the observation group and the control group respectively were 95. 65%,69.57%,and the difference was statistically significant（ P〈0.05）. The weaning time in the observation group was（ 4.2±1.2） d,which was significantly lower than that in the control group of（ 5.8±1.4） d,the difference was statistically significant（ P〈0. 05）. Conclusions The implementation of invasive mechanical ventilation for pulmonary tuberculosis and severe respiratory failure,when the pulmonary infection was controlled,noninvasive sequential mechanical ventilation could shorten the duration of mechanical ventilation,the clinical efficacy is good,and thus it is worthy to be promoted in the clinical.