重症老年呼吸衰竭患者采取有创无创序贯机械通气抢救的效果分析

Effect analysis of invasive and noninvasive sequential mechanical ventilation in senile severe respiratory failure patients

目的探讨重症老年呼吸衰竭患者采取有创无创序贯机械通气的抢救效果。方法将2017年6月至2018年5月接诊的86例重症老年呼吸衰竭患者,按随机数表法分为对照组和研究组各43例,对照组采取有创机械通气治疗,研究组采取有创无创序贯机械通气治疗。比较两组撤机成功率、再插管率、呼吸机相关性肺炎发生率、死亡发生率以及血气和呼吸应激反应等指标情况。结果研究组撤机成功率88.37%明显高于对照组的48.84%;再插管率4.65%、呼吸机相关性肺炎发生率6.98%、死亡率4.65%等均明显低于对照组的20.93%、23.26%和32.56%;pH、p(O_2)、Sa O_2等指标水平明显高于对照组;p(CO_2)、R R、HR等明显低于对照组,差异均有统计学意义(P<0.05)。结论在重症老年呼吸衰竭患者的抢救治疗中采用有创无创序贯机械通气效果显著,可有效提高撤机成功率,减少再插管、呼吸机相关性肺炎和死亡发生率,并能有效改善患者通气功能,具备安全有效的优势。

Objective To investigate the rescue effect of invasive and noninvasive sequential mechanical ventilation in senile severe respiratory failure patients.Methods 86 cases of senile patients with severe respiratory failure from June 2017 to May 2018 were selected and randomly divided into the control group and the study group by random table method,with 43 cases in each group.The control group was treated with invasive mechanical ventilation while the study group was treated with noninvasive sequential mechanical ventilation.The weaning success rate,the re-intubation rate,the incidence of ventilator associated pneumonia,the death rate and the blood gas and breathing index of the two groups were compared.Results The weaning success rate of the study group was 88.37%,significantly higher than that of the control group(48.84%).The re-intubation rate was 4.65%,the incidence of ventilator associated pneumonia was 6.98%and the death rate was 4.65%,significantly lower than those of the control group(20.93%,23.26%and 32.56%).The levels of pH,p(O2)and SaO2 were significantly higher than those of the control group while the levels of p(CO2),RR,HR were significantly lower than those of the control group.The difference was statistically significant(P<0.05).Conclusion The invasive and noninvasive sequential mechanical ventilation achieved remarkable effect in the treatment and rescue of elderly severe respiratory failure patients.It could improve the weaning success rate,lower re-intubation rate,the incidence of ventilator associated pneumonia and the death rate.It could effectively improve the ventilation function of patients and enjoyed the advantages of being safe and effective.