摘要
目的 探讨有创与无创序贯性机械通气在危重肺心病呼吸衰竭患者救治中的方法与疗效。方法 对 4 8例危重肺心病呼吸衰竭患者进行气管插管并人工机械通气 ,将在有创机械通气5d之内符合无创通气标准的 36例患者随机分为两组 ,每组 18例。Ⅰ组给予拔除气管插管改面罩机械通气 ,Ⅱ组继续有创机械通气 ,两组同时进行监护 ,观察两组患者病情变化、血气分析、呼吸机相关肺炎 (VAP)例数、死亡例数、机械通气时间及住院时间。结果 Ⅰ、Ⅱ两组患者发生VAP的例数分别为 0和 6例 (P <0 0 5 ) ,总机械通气时间为 (13± 6 )d和 (2 2± 14 )d(P <0 0 5 ) ;住院时间为(16± 6 )d和 (2 8± 12 )d(P <0 0 5 )。结论 在适当时机将有创通气改为无创通气 ,可降低危重肺心病呼吸衰竭患者VAP发生率 ,缩短机械通气时间和住院时间 ,降低医疗费用 ,是救治危重肺心病呼吸衰竭患者值得提倡的机械通气策略。
Objective To explore the methods and evaluate the efficacy of sequential mechanical ventilation,ie,short-tem invasive mechanical ventilation followed by non-invasive in cor pulmonale patients with respiratory failure.Methods 48 cases with severe cor pulmonale with respiratory failure received intubation and mechanical ventilation.After 5 days 36 cases fit to the criteria of non-invasive mechanical ventilation were divided into two groups randomly.The early extubation was conducted and non-invasive mechanical ventilation via facial mask was took immediately in group Ⅰ while those in group Ⅱ were continously received invasive mechanical ventilation.Blood gas results,the incidence of VAP and mortality,the duration of mechanical ventilation and hospital stay and were analyzed and compared.Results For groupⅠand groupⅡ,the incidence of VAP was 0/18 vs 6/18 (P<0.05).The duration of mechanical ventilation was (13±6)d vs (22±14)d (P<0.05).The duration of hospital stay was (16±6)d vs (28±12)d (P<0.05),respectively.Conclusions In cor pulmonale patients with respiratory failure requiring intubation and mechanical ventilation,early extubation and non-invasive mechanical ventilation initiated at a suitable point may decease the incidence of VAP,the durations of mechanical ventilation,hospital stay and medical care cost which should be a recommended strategy for mechanical ventilation in cor pulmonale with respiratory failure.
出处
《中国呼吸与危重监护杂志》
CAS
2004年第2期94-96,共3页
Chinese Journal of Respiratory and Critical Care Medicine
基金
全军"十五"重点项目资助 (0 1Z0 74)
