摘要
目的观察不同通气模式在慢性阻塞性肺疾病(COPD)急性加重合并呼吸衰竭患者中的临床效果,为临床治疗提供参考依据。方法收集临床诊断为COPD急性加重合并呼吸衰竭的患者26例,采用随机数字表法将其分为两组,每组各13例,分别为同步间歇指令性通气(SIMV)+压力支持通气(PSV)模式组和适应性压力支持(ASV)模式组,比较两组患者治疗前及治疗3d后的体温、心率、呼吸频率及血气分析指标,比较两组患者的有创通气时间、呼吸机相关肺炎(VAP)的发生率、住院时间及不良反应发生情况。结果治疗后两组患者的心率、呼吸频率及血气分析指标与治疗前相比,差异均有统计学意义(P<0.05)。ASV模式组患者的有创通气时间及住院时间均少于SIMV+PSV模式组,差异有统计学意义(P<0.05)。ASV模式组和SIMV+PSV模式组的VAP发生率分别为7.7%、15.4%,总不良反应发生率分别为30.8%、38.6%,差异均无统计学意义(P>0.05)。结论 ASV模式对COPD急性加重合并呼吸衰竭患者的临床效果较SIMV+PSV模式好,推荐在临床上应用。
Objective To observe the clinical effect of different modes of mechanical ventilation for acute exacerbation chronic obstructive pulmonary disease（COPD）patients combined with respiratory failure,and to provide the reference for the clinical treatment.Methods 26 cases of COPD patients combined with respiratory failure were enrolled in the study,and randomly divided into two groups：synchronized intermittent mandatory ventilation（SIMV）＋pressure support ventilation（PSV）model group（n=13）and adaptive support ventilation（ASV）model group（n=13）.The body temperatures,heart rates,respiratory frequencies and blood gas analysis indexes of two groups were compared before treatment and 3dafter treatment,respectively.The invasive mechanical ventilation times,ventilator associated pneumonia（VAP）incidences,length of hospital stay and adverse reaction rates of two groups were also compared.Results After treatment,the heart rates,respiratory frequencies and blood gas analysis indexes of two groups were significantly different with those before treatment（P〈0.05）.The invasive mechanical ventilation time and length of hospital stay of ASV model group were significantly shorter than those of SIMV＋PSV model group（P〈0.05）.The VAP incidences of ASV model group and SIMV＋PSV model group were 7.7%and 15.4%,and the total adverse reaction rates of two group were 30.8% and 38.6% respectively,with no significant difference（P〉0.05）.Conclusion The clinical effect of ASV model is better than SIMV＋PSV model in the treatment of patients of acute exacerbation COPD combined with respiratory failure,which is worthy of promotion.
出处
《检验医学与临床》
CAS
2015年第20期3028-3030,共3页
Laboratory Medicine and Clinic
关键词
慢性阻塞性肺疾病
呼吸衰竭
机械通气
适应性压力支持通气
chronic obstructive pulmonary disease
respiratory failure
mechanical ventilation
adaptive pressure support ventilation
