重症肺炎伴呼吸衰竭治疗中有创-无创序贯机械通气的效果

Effect Analysis of Invasive Non-invasive Sequential Mechanical Ventilation in the Treatment of Severe Pneumonia with Respiratory Failure

目的:研究重症肺炎合并呼吸衰竭患者治疗中有创-无创序贯机械通气的效果。方法:选取2018年1月-2020年1月本院60例重症肺炎合并呼吸衰竭患者,按照随机数字表法分为对照组和研究组,各30例,对照组采用有创机械通气治疗,研究组采用有创-无创序贯机械通气治疗;比较两组治疗前后炎症反应指标(肿瘤坏死因子-α、核因子-κB、白介素-6)、血气指标(二氧化碳分压、氧分压、pH值)水平与临床指标(撤机成功率、有创通气时间、机械通气时间、住院时间、呼吸机相关性肺炎发生率)。结果:研究组治疗后肿瘤坏死因子-α、核因子-κB、白介素-6较对照组更低,撤机成功率更高,呼吸机相关性肺炎发生率更低,有创通气时间、机械通气时间及住院时间更短,差异有统计学意义(P<0.05);两组治疗后二氧化碳分压、氧分压、pH值比较差异无统计学意义(P>0.05)。结论:相较于有创机械通气,重症肺炎合并呼吸衰竭患者治疗中有创-无创序贯机械通气的疗效更优,可进一步减轻患者炎症反应,改善血气状况,减少呼吸机相关性肺炎,撤机成功率更高,且有创通气、机械通气时间更短,可促使患者快速康复。

Objective:To study the effect of invasive non-invasive sequential mechanical ventilation in the treatment of severe pneumonia complicated with respiratory failure.Method:A total of 60 patients with severe pneumonia and respiratory failure admitted from January 2018 to January 2020 were divided into the control group and the study group,30 cases in each group.The control group was treated with invasive mechanical ventilation and the study group was treated with invasive non-invasive sequential mechanical ventilation.The inflammatory response indexes (tumour necrosis factor-α,nuclear factor-κB,interleukin-6),the blood gas indexes (carbon dioxide partial pressure,oxygen partial pressure,pH value) before and after treatment,the clinical indexes (success rate of ventilator withdrawal,invasive ventilation time,mechanical ventilation time,hospitalization time,incidence of ventilator-associated pneumonia) were compared between the two groups.Result:Compared with the control group,the levels of tumor necrosis factor-α,nuclear factor-κB,interleukin-6 in the study group were lower,the success rate of ventilator withdrawal was higher,the incidence of ventilator-associated pneumonia in the study group was lower,the time of invasive ventilation,mechanical ventilation and hospital stay in the study group were shorter,the differences were statistically significant (P<0.05).After treatment,there were no significant differences in carbon dioxide partial pressure,oxygen partial pressure and pH value between the two groups (P>0.05).Conclusion:Compared with invasive mechanical ventilation,invasive non-invasive sequential mechanical ventilation is more effective in the treatment of severe pneumonia with respiratory failure.It can further reduce the inflammatory reaction,improve the blood gas status,reduce ventilator-related pneumonia,and the success rate of ventilator withdrawal is higher,and the invasive ventilation and mechanical ventilation time are shorter,which can promote the patient rapid recovery.