不同呼吸机通气模式治疗ICU重症慢性阻塞性肺疾病合并呼吸衰竭的临床效果

Clinical Observation of Different Ventilator Ventilation Modes in Treatment of Severe Chronic Obstructive Pulmonary Disease with Respiratory Failure in ICU

目的探讨不同呼吸机通气模式对重症监护室(ICU)内重症慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者的辅助治疗价值。方法选取北京燕化医院2015年9月至2018年12月收治的88例重症COPD合并呼吸衰竭患者,采用随机数字表法均分两组,每组44例。对照组患者在常规治疗基础上加用有创呼吸机辅助通气,研究组在常规治疗基础上加用有创、无创呼吸机序贯辅助通气。比较两组治疗前后每分钟通气量(VE)、血氧分压(PaO2)、pH、血二氧化碳分压(PCO2)等指标变化情况。结果两组患者治疗前VE、PaO2、pH、PCO2水平比较,差异无统计学意义(P>0.05)。治疗后研究组VE、PaO2、pH水平上升幅度及PCO2水平下降幅度均优于对照组(P<0.05)。结论应用有创、无创呼吸机序贯机械通气有利于重症COPD合并呼吸衰竭患者获得更优疗效。

Objective To explore the value of different ventilators ventilation modes in the adjuvant treatment of patients with severe chronic obstructive pulmonary disease(COPD)and respiratory failure in the intensive care unit(ICU).Methods Eighty-eight severe COPD patients combined with respiratory failure admitted to our hospital from September 2015 to December 2018 were selected and divided into 2 groups based on the random number table method,44 cases per group.In the control group,patients were treated with invasive ventilatorassisted ventilation on the basis of conventional treatment.The study group was treated with invasive and noninvasive ventilator sequential assisted ventilation on the basis of conventional treatment.The levels of VE,PaO2,pH and PCO2 between the two groups before and after treatment were compared.Results There were no significant difference in the levels of VE,PaO2,pH and PCO2 between the two groups before treatment(P>0.05).After treatment,the improvements of VE,PaO2,PCO2,and pH levels in the study group were better than those in the control group(P<0.05).Conclusion The application of invasive and non-invasive ventilator sequential mechanical ventilation is beneficial to patients with severe COPD combined with respiratory failure.