有创-无创序贯通气治疗肺心病呼吸衰竭危重患者的效果

Effect of Invasive-Non-invasive Sequential Ventilation Therapy on Critical Patients with Pulmonary Heart Disease and Respiratory Failure

目的探讨有创-无创序贯通气治疗肺心病呼吸衰竭危重患者的效果。方法选取2017年2月至2018年2月西部战区总医院呼吸内科收治的50例肺心病呼吸衰竭危重疾病患者。采用掷硬币法随机分为两组,每组25例。对照组采取有创通气治疗,观察组则采取有创-无创序贯性通气方案治疗,比较两组通气治疗的总时间、有创通气治疗的时间、重症监护室监护的时间、再插管发生率、呼吸机相关性肺炎发生率、死亡率;治疗前后患者呼吸频率、血氧分压、二氧化碳分压、平均血压。结果两组患者治疗后的呼吸频率、血氧分压、二氧化碳分压、平均血压较治疗前明显改善(P<0.05)。观察组的通气治疗的总时间、有创通气治疗的时间、重症监护室监护的时间、再插管发生率、呼吸机相关性肺炎发生率、死亡率均低于对照组(P<0.05)。结论有创-无创序贯性通气方案治疗肺心病呼吸衰竭危重疾病效果确切。

Objective To investigate the effect of invasive-non-invasive sequential ventilation therapy on critical patients with pulmonary heart disease and respiratory failure.Methods A total of 50 critical patients with respiratory failure due to pulmonary heart disease admitted to the Department of Respiratory Medicine,General Hospital of the Western Theater from February 2017 to February 2018 were enrolled and randomly divided into 2 groups,25 cases per group.The control group was treated with invasive ventilation,and the observation group was treated with invasive-non-invasive sequential ventilation.The total time of ventilation therapy,the time of invasive ventilation,the time of intensive care unit monitoring,the incidence of reintubation,the incidence of ventilator-associated pneumonia,and the mortality rate,as well as respiratory rate,partial pressure of oxygen,partial pressure of carbon dioxide,and mean blood pressure before and after treatment were compared between the two groups.Results The respiratory rate,partial pressure of oxygen,partial pressure of carbon dioxide,and mean blood pressure after treatment were improved in the two groups compared with before treatment(P<0.05).The total time of ventilation therapy,the time of invasive ventilation,the time of intensive care unit monitoring,the incidence of reintubation,the incidence of ventilator-associated pneumonia,and the mortality rate of the observation group were lower than those of the control group(P<0.05).Conclusion Invasive-noninvasive sequential ventilation is effective in the treatment of critical patients with pulmonary heart disease and respiratory failure.