膈肌起搏器在慢性阻塞性肺疾病呼吸机依赖患者脱机中的应用临床疗效观察

The Applicationand Efficacy of Diaphragmatic Pacemakerin Ventilator-Dependent Patients with Chronic Obstructive Pulmonary Disease(COPD)

目的:探讨慢性阻塞性肺疾病(COPD)呼吸机依赖患者膈肌起搏器的应用及疗效。方法:把2018年6月~2019年6月本院呼吸内科收治的COPD使用呼吸机并发生依赖的清醒患者60例作为研究对象,男27例,女33例;患者年龄60~75岁,平均(66.3±1.2)岁,随机分为观察组(运用常规治疗及护理并增加使用膈肌起搏器)和对照组(运用常规治疗及护理),每组30例,对两组脱机成功率和脱机时间进行比较。结果:观察组患者脱机情况明显优于对照组,观察组与对照组2周脱机成功率分别为83.3%和46.7%,脱机时间分别为(7.56±1.45),(9.42±1.28)d,差异均有统计学意义(P<0.05)。结论:COPD呼吸机依赖患者准备脱机前,给予膈肌起搏器治疗,可明显提高脱机成功率及缩短呼吸机使用时间。

Objective:To explore the application and efficacy of diaphragm pacemakers in patients with chronic obstructive pulmonary disease(COPD)dependent on ventilator.Methods:From June 2018 to June 2019,60 awake patients with COPD who used ventilator and developed dependence who were admitted to the Department of Respiratory Medicine of our hospital were used as the research objects,27 males and 33 females;patients were 60-75 years old,average(66.3±1.2)years old,randomly divided into observation group(using conventional treatment and nursing and increasing the use of diaphragm pacemaker)and control group(using conventional treatment and nursing),30 cases in each group,the offline success rate and offline time of the two groups were compared.Results:The patients in the observation group were significantly better offline than the control group.The 2-week weaning success rates of the observation group and the control group were 83.3%and 46.7%,respectively,and the offline time was(7.56±1.45),(9.42±1.28)d,the differences were statistically significant(P<0.05).Conclusion:COPD ventilator relies on patients to be given diaphragm pacemaker therapy before going offline,which can significantly improve the success rate of weaning and shorten the time of ventilator use.