序贯机械通气联合参麦注射液治疗COPD重症呼吸衰竭临床研究

Clinical study of sequential mechanical ventilation combined with shenmai injection in treatment of COPD severe respiratory failure

目的研究序贯机械通气与参麦注射液联合治疗慢性阻塞性肺疾病(COPD)重症呼吸衰竭的临床疗效。方法选取98例2019年12月—2020年12月永煤集团总医院收治的COPD重症呼吸衰竭患者,以治疗方式不同分为对照组(n=49,开展常规有创机械通气治疗)和观察组(n=49,采用序贯机械通气与参麦注射液联合治疗),对比两组的治疗结果。结果治疗后,对比两组肺功能与血气指标,显示观察组用力肺活量(FVC)(2.84±0.79)L、第1秒钟用力呼吸容积(FEV1)(2.38±0.48)L、二氧化碳分压(PaCO2)(33.09±1.13)mm Hg以及血氧分压(PaO2)(95.16±16.33)mm Hg水平均明显优于对照组,差异有统计学意义(t=4.5990,t=4.5269,t=33.24922,t=2.065,P<0.05);观察组的有创通气时间(171.03±12.24)h、总机械通气时间(244.31±25.78)h明显低于对照组,差异有统计学意义(t=50.8976,t=30.9634,P<0.05);且观察组的呼吸机相关性肺炎(VAP)发生率(2.04%)低于对照组(16.32%),组间对比有统计学意义(χ^(2)=5.9950,P<0.05)。结论序贯机械通气与参麦注射液联合治疗COPD重症呼吸衰竭可有效改善患者的临床症状,减少VAP的发生,疗效显著,值得推广。

Objective To study the clinical efficacy of sequential mechanical ventilation combined with Shenmai injection in the treatment of severe respiratory failure in chronic obstructive pulmonary disease(COPD).Method Choose 98 cases in December 2019-December 2020,wing coal group general hospital treating COPD patients with severe respiratory failure,using various treatment were randomly divided into control group(n=49,carry out routine invasive mechanical ventilation treatment)and observation group(n=49,using sequential mechanical ventilation with ginseng injection combination therapy),comparing the two groups of treatment.Results After treatment,lung function and blood gas indexes were compared between the two groups.The results showed that the forced vital capacity(FVC)(2.84±0.79)L,the forced breathing volume of the first second(FEV1)(2.38±0.48)L,the partial pressure of carbon dioxide(PaCO2)(33.09±1.13)mm Hg and the partial pressure of blood oxygen(PaO2)(95.16±16.33)mm Hg were significantly higher in the observation group The difference was statistically significant(t=4.5990,t=.5269,t=33.24922,t=2.065,P<0.05).The invasive ventilation time(171.03±12.24)h and total mechanical ventilation time(244.31±25.78)h in the observation group were significantly lower than those in the control group,and the differences were statistically significant(t=50.8976,t=30.9634,P<0.05).The incidence of ventilator associated pneumonia(VAP)in the observation group(2.04%)was lower than that in the control group(16.32%),and the comparison between groups was statistically significant(χ^(2)=5.9950,P<0.05).Conclusion The combination of sequential mechanical ventilation and Shenmai injection in the treatment of COPD severe respiratory failure can effectively improve the clinical symptoms of patients,reduce the occurrence of VAP,and the efficacy is significant,worthy of promotion.