有创-无创序贯机械通气治疗AECOPD合并Ⅱ型呼吸衰竭的诊治体会

Experience in Diagnosis and Treatment of AECOPD with Type Ⅱ Respiratory Failure by Invasive and Non-invasive Sequential Mechanical Ventilation

目的:研究有创-无创序贯机械通气治疗AECOPD合并Ⅱ型呼吸衰竭的诊治体会。方法:选择2015年2月~2016年9月某院接诊的AECOPD合并Ⅱ型呼吸衰竭患者80例,随机分成观察组和对照组,每组40例。在出现"肺部感染控制窗PIC(窗)"后,观察组采用有创-无创序贯通气治疗,对照组继续有创机械通气治疗方法。结果:两组患者有创通气时间、ICU住院时间、VAP发生率均有统计学意义(P<0.05),两组患者院内死亡率比较无明显差异(P>0.05)。结论:有创-无创序贯机械通气治疗AECOPD合并Ⅱ型呼吸衰竭的临床治疗,可以缩短患者机械通气时间,降低VAP发生率,具有较明显的治愈率和使用价值,可以使患者有效脱机,值得广泛应用。

Objective：To study on the experience in diagnosis and treatment of AECOPD with typeⅡrespiratory failure by invasive and non-invasive sequential mechanical ventilation.Methods：80 cases of AECOPD patients complicated with type Ⅱ respiratory failure treated in a hospital from February 2015 to September 2016 were selected and randomly divided into observation group and control group,with 40 cases in each group.In the presence of ＂pulmonary infection control window PIC（window）＂,the observation group was treated with invasive and non-invasive sequential ventilation,while the control group continued invasive mechanical ventilation.Results：There was significant difference in the duration of invasive ventilation,duration of hospitalization in ICU,and the incidence of VAP between the two groups（P〈0.05）.There was no significant difference in hospital mortality between the two groups（P〈0.05）.Conclusion：The clinical treatment of AECOPD complicated with type Ⅱ respiratory failure by invasive and non-invasive sequential mechanical ventilation can shorten the time of mechanical ventilation and reduce the incidence of VAP,which has obvious cure rate and use value,can be effectively taken off line,and is worthy of wide application.