无创正压通气联合痰液引流装置在老年重症肺炎患者治疗中的应用价值

Clinical Value of Noninvasive Positive Pressure Ventilation Combined with Sputum Drainage Device in the Treatment of Elderly Patients with Severe Pneumonia

目的观察老年重症肺炎患者使用无创呼吸机代替常规有创呼吸机治疗的安全性和有效性。方法选取2015年5月至2017年5月收治的老年重症肺炎患者50例,将其分为对照组27例和试验组23例,试验组给予经皮气管穿刺接小口径吸痰装置,联合无创通气行微创化呼吸道管理;对照组给予传统的气管插管行有创呼吸道管理。比较两组相关临床指标。结果治疗后,两组心率、血气分析指标均较治疗前改善,差异均有统计学意义(P<0.05);试验组机械通气(MV)时间、ICU住院时间、抗生素使用时间、咪达唑仑用量、VAP发生率、气管切开率均优于对照组,差异均有统计学意义(P<0.05)。结论微创化床边吸痰装置联合无创呼吸机在老年重症肺炎患者呼吸道管理中应用明显优于传统大口径气管插管吸痰方法,值得推广。

Objective o observe the safety and efficacy of non-invasive ventilator in the treatment of elderly patients with severe pneumonia and the treatment of conventional invasive ventilator.Methods Twenty-three patients with severe pneumonia were divided into minimally experimental group and control group(n=27).The experimental group was given percutaneous tracheal puncture with smallcaliber suction device,combined with noninvasive ventilation line minimally invasive respiratory management.The control group was given conventional tracheal intubation for invasive respiratory management.The two groups of clinical indicators outcome.Results After treatment,the heart rate and blood gas analysis indexes of the two groups were significantly improved compared with those before treatment(P<0.05).The time of MV time,ICU hospitalization day,antibiotic use time,midazolam dosage,VAP incidence,tracheostomy rate of the experimental group were better than the control group,the differences were statistically significant(P<0.05).Conclusion The minimally invasive bedside suction device combined with noninvasive ventilator is superior to traditional large diameter tracheal intubation in the treatment of respiratory tract,it is worthy of clinical promotion.