无创和有创机械通气治疗肺性脑病的临床疗效分析

Clinical Analysis of Noninvasive and Invasive Mechanical Ventilation in Treatment of Pulmonary Encephalopathy

目的分析慢性阻塞性肺疾病(COPD)合并肺性脑病患者分别采用无创通气以及有创机械通气治疗的临床疗效。方法方便选取该院2013年6月—2016年9月收治的103例COPD合并肺性脑病患者,按照不同的治疗方法随机分为治疗组(52例,采用有创-无创序贯机械通气治疗)和对照组(51例,采用有创机械通气治疗),对比两组患者有创机械通气时间、总机械通气时间、住院时间、住院费用以及并发症发生率。结果治疗组患者有创机械通气时间(5.71±2.19)d、总机械通气时间(10.11±2.99)d、住院时间(10.21±3.87)d及住院费用(30 571.21±308.31)元明显少于对照组(P<0.05)。治疗组VAP、气胸等并发症发生率9.6%明显低于对照组33.3%。结论 COPD合并肺性脑病患者采用有创-无创序贯机械通气治疗的效果更佳,可有效缩短机械通气时间以及住院时间,减少VAP发生,减少住院费用,值得广泛推广应用。

Objective This paper tries to analyze the clinical efficacy of noninvasive ventilation and invasive mechanical ventilation in patients with chronic obstructive pulmonary disease（COPD）complicated with pulmonary encephalopathy.Methods 103 cases of COPD patients with pulmonary encephalopathy in this hospital from June 2013 to September 2016 were conveniently selected, according to the different treatment methods, they were randomly divided into the treatment group（52 cases, using sequential invasive noninvasive mechanical ventilation treatment） and the control group（51 cases, using non-invasive mechanical ventilation）, and the invasive mechanical ventilation time, total mechanical ventilation time,hospitalization time,hospitalization expenses and complications of the two groups were compared. Results The time of mechanical ventilation was（5.71±2.19）d, the total mechanical ventilation time was（10.11±2.99）d, the hospitalization time was（10.21±3.87） d and the hospital cost was（30 571.21±308.31）yuan, significantly less than those in the control group（P0.05）.The incidence of complications such as VAP and pneumothorax in treatment group was 9.6%, significantly lower than that in control group of 33.3%. Conclusion Using invasive noninvasive sequential mechanical ventilation treatment for COPD patients with pulmonary encephalopathy is better, which can effectively shorten the time of mechanical ventilation and hospitalization time, reduce the incidence of VAP, reduce the cost of hospitalization, therefore it is widely used.