重症慢性阻塞性肺疾病Ⅱ型呼吸衰竭患者的有创和无创呼吸机序贯治疗效果分析

Analysis of the Sequential Treatment Effects of Invasive and Non-Invasive Ventilators on Patients withSevere Chronic Obstructive Pulmonary Disease Type II Respiratory Failure

目的:分析有创和无创呼吸机序贯治疗对重症慢性阻塞性肺疾病Ⅱ型呼吸衰竭患者的效果。方法:选取2018年1月~2023年1月本院收治的重症慢性阻塞性肺疾病Ⅱ型呼吸衰竭患者68例,随机分为对照组和观察组,给予对照组患者有创通气治疗,观察组采取有创和无创呼吸机序贯治疗。结果:治疗后72h,两组患者呼吸频率、心率指标水平差异无统计学意义(P>0.05);观察组患者住院时间、通气时间以及通气总时间均短于对照组(P<0.05);观察组患者再插管率5.88%(2/34)低于对照组再插管率29.41%(10/34)(P<0.05);观察组呼吸机相关肺炎发生率1/33(3.03%)低于对照组发生率4/34(11.76%)(P<0.05)。对比两组患者干预前后动脉血氧分压和动脉血二氧化碳分压水平,干预前两组患者血气指标无明显差异(P>0.05)干预后,观察组血气指标优于对照组(P<0.05)。结论:对重症慢性阻塞性肺疾病Ⅱ型呼吸衰竭患者采取有创和无创呼吸机序贯治疗,可以提升治疗效果,缩短住院、通气、总通气时间,降低再插管率以及呼吸机相关肺炎发生率,更好地改善患者的血气指标。

Objective:To analyze the effectiveness of sequential treatment with invasive and non-invasive ventilators in patients with severe chronic obstructive pulmonary disease type II respiratory failure.Methods:68 patients with severe chronic obstructive pulmonary disease type II respiratory failure admitted to our hospital from January 2018 to January 2023 were randomly divided into a control group and an experimental group.The control group received invasive ventilation treatment,while the experimental group received sequential treatment with invasive and non-invasive ventilators.The vital signs,hospitalization time,ventilation time,total ventilation time,and reintubation rate of the two groups of patients were compared 72 hours after treatment The incidence of ventilatorassociated pneumonia(VAP)and the levels of blood gas indicators(PaO2,PaCO2).Results:72 hours after treatment,there was no significant difference in respiratory rate and heart rate between the two groups(P>0.05);The hospitalization time,ventilation time,and total ventilation time of the experimental group patients were shorter than those of the control group(P<0.05);The reintubation rate of patients in the experimental group was 5.88%(2/34)lower than that in the control group,which was 29.41%(10/34)(P<0.05);The incidence of ventilator-associated pneumonia(VAP)in the experimental group was 1/33(3.03%)lower than that in the control group,which was 4/34(11.76%)(P<0.05).Comparing the levels of(PaO2)and(PaCO2)between the two groups of patients before and after intervention,there was no significant difference in blood gas indicators between the two groups before and after intervention(P>0.05).After intervention,the blood gas indicators of the experimental group were better than those of the control group(P<0.05).Conclusion:Sequential treatment with invasive and non-invasive ventilators can improve treatment effectiveness,shorten hospitalization,ventilation,and total ventilation time,reduce reintubation rates and the incidence of ventilator-associated pneumonia(VAP)in patients with severe chronic obstructive pulmonary disease type II respiratory failure,and better improve patient blood gas indicators.