【摘要】 目的探讨有创-无创序贯机械通气在慢性阻塞性肺疾病(COPD)重症呼吸衰竭治疗中的作用,以及以肺部感染控制窗(PIC)为切换点转换通气模式的效果。方法分析本院呼吸科监护病房(RICU)48例COPD重症呼吸衰竭,分别接受有创-无创序贯机械通气(实验组)及传统气管插管机械通气(对照组)患者的病例资料。结果实验组有创机械通气和入住RICU的时间较对照组明显缩短(P<0.05),呼吸机相关肺炎(VAP)发生率减低(P<0.05);两组的再插管率和病死率无显著性差异(P>0.05)。结论对于COPD重症呼吸衰竭,以PIC窗为切换点,实施有创-无创序贯机械通气,能收到良好的治疗效果。更多还原

【Abstract】 [Objective]To explore sequential invasive and non-invasive mechanical ventilation in patients with chronic obstructive pulmonary disease (COPD) with severe respiratory failure and the effect of pulmonary infection control (PIC) window switching point conversion ventilation. [Methods] The clinical data of forty-eight cases of COPD with severe respiratory failure in Respiratory Intensive Care Unit (RICU) from January 2006 to October 2009 were retrospectively analyzed. These patients received either tracheal intubation (control group) or sequential invasive and non-invasive mechanical ventilation (experimental group).[Results] Experiment group had shorter duration of both total ventilation support and RICU stay (P <0.05), and the ratio of VAP was lower than that of control group (P <0.05). There was no difference between the two groups in the ratio of reintubation and mortality (P >0.05). [Conclusion]For COPD patients with severe hypercapnic respiratory failure, early extubation followed by non-invasive mechanical ventilation at the point of PIC windows may get better effect.更多还原