【摘要】 目的探讨有创与无创序贯机械通气(简称序贯性机械通气)抢救非COPD病因所致严重呼吸衰竭的临床效果及应用价值。方法选择非COPD病因所致呼吸衰竭患者18例为非COPD组,COPD所致呼吸衰竭15例为COPD组。先经口气管插管正压通气,根据病情在3~7天内拔除气管插管改为无创正压通气。观察两组病例的血气分析指标、机械通气时间、呼吸机相关性肺炎发生例数、撤机成功例数、住院死亡例数等。结果非COPD组和COPD组治疗前基础情况匹配良好(P均>0.05)。非COPD组有创通气时间明显长于COPD组(P<0.05),总通气时间、撤机成功例数、住院死亡例数两组均无显著性差异(P>0.05),住院费用明显高于COPD组(P<0.05)。结论序贯性机械通气策略对非COPD病因所致呼吸衰竭可能也具有一定优势。更多还原

【Abstract】 Objective To evaluate the efficacy of early extubation and sequential invasive to noninvasive mechanical ventilation(MV) in treatment of severe respiratory failure due to non-COPD.Methods 18 patients with severe respiratory failure due to non-COPD were involved in the non-COPD group.15 cases with severe respiratory failure from COPD were assigned to COPD group.After 3~7 days intubation and invasive positive pressure MV,the extubation was conducted and followed by noninvasive MV.The markers of blood gas analysis,the duration of MV,the incidence of ventilator-associated pneumonia and the incidence of death were compared between the groups.Results There was no significant differences in the clinical characteristics between the two groups(P>0.05).Compared with the COPD group,the patients in the non-COPD group showed more invasive MV duration(P<0.05) and higher hospitalization cost(P<0.05).There was no significant group difference on the duration of invasive MV,the rate of removing ventilator and the mortality rate(P>0.05).Conclusion Sequential invasive to noninvasive MV strategy could be used in the treatment of severe respiratory failure of non-COPD.更多还原