早期机械通气治疗慢性阻塞性肺疾病并呼吸衰竭的效果

The Effect of Early Mechanical Ventilation on Chronic Obstructive Pulmonary Disease and Respiratory Failure

目的对慢性阻塞性肺疾病(慢阻肺)急性发作并重度呼吸衰竭患者采用早期有创机械通气治疗的效果进行探究。方法选择本院2018年8月—2020年9月收治的慢阻肺急性发作并重度呼吸衰竭患者104例,通过随机盲选的方式将其划分为甲组和乙组,每组各52例。甲组患者在确诊为重度呼吸衰竭的6 h内接受有创通气治疗,乙组患者在确诊为重度呼吸衰竭的6 h后接受有创通气治疗。比较两组的临床指标、治疗效果、并发症情况。结果治疗前,甲组和乙组的动脉血氧分压、动脉血二氧化碳分压比较,差异无统计学意义(P>0.05),治疗后,甲组的动脉血氧分压为(70.8±8.9)mmHg、动脉血二氧化碳为分压为(54.6±5.7)mmHg,明显优于乙组的(52.1±8.2)、(68.1±8.2)mm Hg,差异有统计学意义(P<0.05)。甲组的通气治疗时间为(142.7±12.6)h、住院时间为(9.3±1.8)d,明显短于乙组的(181.3±18.5)h、(14.8±2.1)d,差异有统计学意义(P<0.05)。甲组的总并发症发生率为3.8%,乙组的总并发症发生率为21.2%,甲组的并发症总发生率明显低于乙组,差异有统计学意义(P<0.05)。结论在慢阻肺急性发作合并重度呼吸衰竭的治疗中,采用早期有创机械通气治疗效果确切,可以有效改善患者的血气指标,促进患者的身体康复,而且并发症少,安全有效。

Objective To investigate the effect of early invasive mechanical ventilation in patients with acute onset of chronic obstructive pulmonary disease(COPD)and severe respiratory failure.Methods A total of 104 patients with acute onset of COPD and severe respiratory failure admitted to our hospital from August 2018 to September 2020 were included in this study.They were divided into group A and group B by blind randomized selection,with 52 patients in each group.Patients in group A received invasive ventilation treatment within 6 hours of diagnosis of severe failure,and patients in group B received invasive ventilation 6 hours after diagnosis of severe respiratory failure.Comparison of clinical indicators,treatment effects and complications between the two groups.Results Before treatment,there were no significant differences in arterial blood oxygen partial pressure and arterial blood carbon dioxide partial pressure between group A and group B(P>0.05).After treatment,the partial pressure of arterial oxygen of group A was(70.8±8.9)mmHg,and the partial pressure of carbon dioxide in arterial blood was(54.6±5.7)mmHg,which were significantly better than(52.1±8.2)and(68.1±8.2)mmHg in group B,and the differences were statistically significant(P<0.05).The ventilation treatment time of group A was(142.7±12.6)h,and the hospitalization time was(9.3±1.8)d,which were significantly shorter than(181.3±18.5)h and(14.8±2.1)d of group B,and the differences were statistically significant(P<0.05).The total complication rate of group A was 3.8%,and that of group B was 21.2%,the total complication rate of group A was significantly lower than that of group B,and the difference was statistically significant(P<0.05).Conclusion In the treatment of acute COPD attack combined with toxic respiratory failure,early invasive mechanical ventilation is effective,can effectively improve the blood gas index of patients,promote the physical rehabilitation of patients,and fewer complications,safe and effective.