有创-无创序贯机械通气在重症肺炎治疗中的应用

Application of Invasive-noninvasive Sequential Mechanical Ventilation in the Treatment of Severe Pneumonia

目的分析重症肺炎应用有创-无创序贯机械通气治疗的临床效果。方法于该院急诊病区2016年6月—2019年6月收治的重症肺炎患者中选取68例,分为两组,对照组给予有创机械通气治疗,研究组给予有创-无创序贯机械通气治疗,比较两组治疗效果。结果研究组有创机械通气时间为(4.3±1.1)d,ICU入住时间为(10.3±1.7)d,住院时间为(15.1±3.8)d,与对照组比较差异有统计学意义(t=7.187、11.958、56628,P<0.05)。两组治疗后的OI、Cst以及EVLWI指标比较,差异有统计学意义(t=20.542、7.489、4.629,P<0.05)。研究组呼吸机相关性肺炎发生率为5.9%,再次插管率为8.8%,与对照组的32.4%和35.3%比较,差异有统计学意义(χ2=7.704、6.928,P<0.05)。研究组与对照组病死率分别为2.9%和20.6%,组间差异有统计学意义(χ2=5.100,P<0.05)。结论有创-无创序贯机械通气应用于重症肺炎患者,可有效改善患者肺功能,缩短患者有创机械通气时间,从而降低患者的呼吸机相关性肺炎发生风险,改善患者预后。

Objective To analyze the clinical effect of invasive and non-invasive sequential mechanical ventilation on severe pneumonia.Methods 68 patients with severe pneumonia admitted to the emergency ward of our hospital from June 2016 to June 2019 were selected and divided into two groups.The control group was treated with invasive mechanical ventilation,and the study group was treated with invasive and non-invasive sequential mechanical ventilation.The therapeutic effects of the two groups were compared.Results The duration of invasive mechanical ventilation(4.3±1.1)d,ICU stay(10.3±1.7)d,and stay(15.1±3.8)d in the study group were statistically significantly different from the control group(t=7.187,11.958,5662,P<0.05).Comparison of OI,Cst and EVLWI after treatment between the two groups showed statistical difference(t=20.542,7.489,4.629,P<0.05).The incidence of ventilators associated pneumonia in the study group was 5.9%,and the rate of re-intubation was 8.8%,which was statistically significantly different from 32.4%and 35.3%in the control group(χ2=7.704,6.928,P<0.05).The mortality rates of the study group and the control group were 2.9%and 20.6%,respectively,with statistically significant differences between the groups(χ2=5.100,P<0.05).Conclusion Invasive and non-invasive sequential mechanical ventilation can effectively improve the lung function of patients with severe pneumonia,short-en the duration of invasive mechanical ventilation,thereby reducing the risk of ventilators associated pneumonia and improving the prognosis of patients.