PIC窗序贯通气对AECOPD并呼吸衰竭患者治疗期间血气指标及预后的影响

Effect of PIC Window Sequential Ventilation on Blood Gas Index and Prognosis of Patients with AECOPD and Respiratory Failure during Treatment

目的探讨肺部感染控制(PIC)窗序贯通气对慢性阻塞性肺疾病急性加重(AECOPD)并呼吸衰竭患者治疗期间血气指标及预后的影响。方法纳入本院于2018年3月至2020年3月收治的84例AECOPD合并呼吸衰竭患者实施研究,均接受抗感染、营养支持、化痰平喘及酸碱平衡纠正等对症治疗,按随机数字表法设对照组及观察组,对照组予以有创正压机械通气(IPPV),观察组则行PIC窗有创-无创序贯通气治疗,比较两组肺功能、血气指标及预后。结果经治疗,观察组FEV1%、FVC与对照组比较均更高(P<0.05);两组PH、SaO_(2)、PaO_(2)均有提升,PaCO_(2)则见下降,观察组PH、SaO_(2)、PaO_(2)较对照组均更高,PaCO_(2)则更低(P<0.05);观察组IPPV时间、机械通气时间、ICU住院时间、APACHEⅡ评分、拔管失败再插管率及VAP率均低于对照组(P<0.05),两组病死率比较差异无统计学意义(P>0.05)。结论AECOPD合并呼吸衰竭患者应用PIC窗序贯通气治疗,可在一定程度上提升肺功能,使血气指标获得改善,且IPPV时间、机械通气时间、ICU住院时间缩短,APACHEⅡ评分降低,拔管失败再插管率、VAP率减少,有利于预后转归。

Objective To investigate the effect of sequential ventilation of lung infection control(PIC)window on blood gas indexes and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and respiratory failure during treatment.Methods The 84 patients with AECOPD and respiratory failure admitted to our hospital from March 2018 to March 2020 were included in the study.They all received symptomatic treatments such as anti-infection,nutritional support,phlegm and asthma,and acid-base balance correction.They were randomized The digital table method set up a control group and an observation group.The control group received invasive positive pressure mechanical ventilation(IPPV),and the observation group received PIC window invasive-noninvasive sequential ventilation therapy.The lung function,blood gas indicators and prognosis of the two groups were compared.Results After treatment,FEV_(1)%and FVC in the observation group were higher than those in the control group(P<0.05);PH,SaO_(2) and PaO_(2) in the two groups increased,while PaCO_(2) decreased.The PH,SaO_(2) and PaO_(2) in the observation group were compared with the control group.The group was higher,and PaCO_(2) was lower(P<0.05);The observation group’s IPPV time,mechanical ventilation time,ICU hospital stay,APACHEⅡscore,failed extubation and reintubation rates,and VAP rates were lower than those in the control group(P<0.05),there was no significant difference in mortality between the two groups(P>0.05).Conclusion The application of PIC window sequential ventilation therapy in patients with AECOPD and respiratory failure can improve lung function to a certain extent,improve blood gas indicators,and shorten IPPV time,mechanical ventilation time,and ICU hospitalization time,reduce APACHEⅡscore,and fail extubation before reinsertion.The reduction of tube rate and VAP rate is conducive to the prognosis.