机械通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者的疗效研究

Study on efficacy of mechanical ventilation in the treatment of patients with chronic obstructive pulmonary disease complicated with respiratory failure

目的探究机械通气治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭(呼衰)患者的临床疗效。方法 100例COPD合并呼衰患者,按照随机分组的方式分为A组和B组,各50例。两组患者均在常规治疗的基础上实施有创机械通气治疗,A组患者行早期机械通气,B组患者行延迟机械通气。对两组患者的临床疗效进行比较。结果两组患者治疗后动脉血二氧化碳分压(PaCO_2)和氧合指数(PaO_2/FiO_2)水平均有所改善,且A组患者PaCO_2和PaO_2/FiO_2水平明显优于B组,差异具有统计学意义(P<0.05)。A组患者住院时间为(17.4±3.7)d、有创通气时间为(58.8±13.3)h及机械通气总时间为(156.6±28.7)h均明显短于B组的(20.3±4.2)d、(104.4±26.8)h、(190.1±42.5)h,差异具有统计学意义(P<0.05)。A组患者呼吸机相关性肺炎(VAP)发生率为6%、脱机成功率为94%均优于B组的22%、64%,差异具有统计学意义(P<0.05)。结论早期有创机械通气治疗COPD合并呼衰患者的疗效安全可靠,对患者治疗和住院时间的缩短、预后的改善具有明显效果,值得临床推广及应用。

Objective To investigate the clinical efficacy of mechanical ventilation in the treatment of patients with chronic obstructive pulmonary disease（COPD） complicated with respiratory failure.Methods A total of 100 patients with COPD complicated with respiratory failure were randomly divided into group A and group B,with 50 cases in each group.Both groups was treated with mechanical ventilation on the basis of conventional therapy,and group A also received early mechanical ventilation.Group B received delayed mechanical ventilation.The clinical efficacy in two groups was compared.Results Both groups had better arterial carbon dioxide partial pressure（PaCO_2） and arterial partial pressure of oxygen（PaO_2）/fraction of inspired oxygen（FiO_2）,and group A had obviously better PaCO2 and PaO_2/FiO2 level than group B,and the difference was statistically significant（P0.05）.Group A had obviously shorter hospitalization time as（17.4±3.7） d,invasive ventilation time as（58.8±13.3） h and the total time of mechanical ventilation time as（156.6±28.7） h than（20.3±4.2） d,（104.4±26.8） h and（190.1±42.5） h in group B,and their difference was statistically significant（P0.05）.Group A had incidence of vatilation associated pneumonia（VAP） as 6%,and offline success rate as 94%,which were all better than 22% and 64% in group B,and their difference was statistically significant（P0.05）.Conclusion Early invasive mechanical ventilation for COPD patients with respiratory failure is safe and reliable,and has obvious effects on shortening of hospitalization time and improvement of prognosis.It is worthy of clinical promotion and application.