摘要
目的:探讨无创机械通气在慢性阻塞性肺疾病(COPD)所致急性呼吸衰竭治疗中的临床价值。方法:本组COPD导致急性呼吸衰竭患者136例,随机分成两组,无创组运用面罩无创机械通气,有创组采用气管插管机械通气,记录两组患者心率、呼吸频率、血气分析、呼吸机相关性肺炎发生率、通气时间及住院时间等,并进行比较分析。结果:无创通气组与有创通气组治疗后8h、48h时与治疗前相比,患者呼吸、心率、动脉pH值、PaCO2与PaO2变化差异均有统计学意义,均较治疗前有明显改善(P<0.05)。但治疗后两组间一般情况及动脉血气分析,两组间无显著性差异(P>0.05)。呼吸机相关性肺炎(VAP)的发生率、通气时间、住院时间、病死率两组间差异也有统计学意义(P<0.05)。治疗2周时,两组间APACHEⅡ评分、肺通气功能(FEV1%、FEV1/FVC%)的差异均有显著性差异(P<0.05)。结论:无创与有创通气在辅助治疗COPD所致呼吸衰竭过程中的作用相似,但无创通气可避免气管插管,减少通气时间与住院天数,降低VAP,使用方便易于接受。
Objective： To investigate the clinical effects of noninvasive ventilation on chronic obstructive pulmonary disease （COPD） with respiratory failure.Methods：136 COPD patients with acute respiratory failure were randomly divided into two groups （noninvasive group and invasive group）. The noninvasive group received noninvasive ventilation by facial windpipe incubates and the invasive group were treated by tracheal intubation.Results：The differences were statistically significant between noninvasive and invasive ventilation on ventilation effects and ventilator interrelated pneumonia （P〈 0.05）.APACHE Ⅱ score, and the basic lung function had significant difference in noninvasive group compared with the invasive group（P〈0.05）.Conclusion：Noninvasive ventilation has same effect compared with invasive ventilator in treatment of COPD with respiratory failure. While it has less ventilator associated pneumonia rate, and easier to be accepted by patients.
出处
《中国医药导报》
CAS
2008年第11期13-15,共3页
China Medical Herald
关键词
慢性阻塞性肺疾病
呼吸衰竭
无创机械通气
Chronic obstructive pulmonary disease
Respiratory failure
Noninvasive ventilation
