摘要
目的观察有创-无创序贯机械通气(MV)治疗重症肺炎(SP)的疗效及安全性。方法选取我院收治的SP患者160例,随机分为对照组和观察组,每组80例。对照组行传统有创MV,观察组行有创-无创序贯MV。记录两组MV时间、住院时间、呼吸机相关性肺炎(VAP)发生率、再次插管率、病死率,同时观察两组静态肺顺应性(Cst)、氧合指数(OI)、乳酸(Lac)、血管外肺水指数(EVLWI)水平变化。结果观察组MV时间、住院时间短于对照组;VAP发生率、再次插管率、病死率低于对照组(P <0.05);治疗后Cst、OI水平两组较治疗前上升,且观察组高于对照组(P<0.05);治疗后Lac、EVLWI水平两组较治疗前下降,且观察组低于对照组(P<0.05)。结论以肺部感染控制窗为切换点行有创-无创序贯MV治疗SP效果良好且安全性高,可有效改善患者肺功能,降低VAP发生率及病死率。
Objective To observe the efficacy and safety of invasive-noninvasive sequential mechanical ventilation(MV)in the treatment of severe pneumonia(SP).Methods A total of 160 patients with SP were selected and randomly divided into the control group and the observation group,80 cases in each group.Control group was given traditional invasive MV and the observation group was given invasive-noninvasive sequential MV.The invasive MV time,hospital stay,incidence rate of ventilator-associated pneumonia(VAP),re-intubation rate and mortality of the two groups were recorded.The levels of static lung compliance(Cst),oxygenation index(OI),lactic acid(Lac)and extravascular lung water index(EVLWI)of the two groups were observed.Results The invasive MV time and hospital stay in observation group were shorter than those in control group and the incidence rate of VAP,rentubation rate and mortality rate were lower than those in control group(P<0.05).After treatment,the levels of Cst and OI increased compared with those before treatment and the levels in observation group were higher than those in control group(P<0.05).The levels of Lac and EVLWI after treatment decreased compared with those before treatment and the levels in observation group were lower than those in control group(P<0.05).Conclusions Invasive-noninvasive sequential MV therapy with PIC window as a switching point has good effect and high safety in the treatment of SP,which can effectively improve lung function and reduce the incidence rate of VAP and the mortality rate.
作者
韩晓红
袁娟
邢学勇
田静
Han Xiaohong;Yuan Juan;Xing Xueyong;Tian Jing(The Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan)
出处
《菏泽医学专科学校学报》
2019年第1期19-22,共4页
Journal of Heze Medical College
关键词
重症肺炎
机械通气
呼吸衰竭
Severe pneumonia
Mechanical ventilation
Respiratory failure
