Application of treating chronic obstructive puImonary disease patients with respiratory failure with the sequential noninvasive and invasive ventilation
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摘要: 目的:探讨有创-无创序贯式治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭中的临床效果。方法:选择COPD合并呼吸衰竭患者64例，临床出现肺部感染控制窗后，将患者随机分为2组:有创-无创序贯式治疗组(观察组)和常规治疗组(对照组)。观察2组患者在出窗时间、有创通气时间、机械通气时间、住院时间、呼吸机相关性肺炎发生率、病死率等各项指标的差异。结果:观察组和对照组出窗时间分别为(6.52.0)d和(7.51.0)d，差异有统计学意义(P0.01)。2组患者出窗时和脱机时呼吸频率、心率、PaO2、PaCO2、pH值比较差异均无统计学意义(P0.05);观察组有创通气时间、总机械通气时间、住院时间均短于对照组(P0.01)，VAP发生率少于对照组(P0.05)，病死率与对照组差异无统计学意义(P0.05)。结论:有创-无创序贯式机械通气治疗COPD合并呼吸衰竭的患者可有效缩短机械通气时间，降低呼吸机相关肺炎的发生率，使患者能够尽快痊愈出院，是一种较为有效的临床治疗方案。Abstract: Objective：To investigate the effects of treatment for chronic obstructive pulmonary disease(COPD) patients with respiratory failure with the sequential noninvasive and invasive ventilation.Methods：Sixty-four COPD patients with respiratory failure were randomly divided into the treatment group(the sequential noninvasive and invasive ventilation group) and the control group.Palmonary infection control(PIC) windows was defined,the the length of ventilation and mechanical ventilation time,hospital stay and the incidence of ventilator associated pneumonia and mortality of all cases were recorded.Results：The time of PIC window of two groups were(6.52.0) and(7.51.0) days respectively(P〈0.01).Compared with the control group,the data of HR,RR,PaO2,PaCO2 and pH of treatmen group had statistically significant difference(P〉0.05).The length of ventilation and mechanical ventilation time,and hospital stay of treatment group were shorter than that of control group(P〈0.01).The incidence of VAP in the treatment group were significant less than that of control group(P〈0.05),and mortality rate was no significant difference(P〉0.05).Conclusions：The method of treating COPD patients with respiratory failure with the sequential noninvasive and invasive ventilation can reduce the length of mechanical ventilation time and the incidence of VAP,which is a potent treatment regimen.
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