【摘要】 目的:比较不同撤机方式对慢性阻塞性肺疾病(COPD)并呼吸衰竭患者行机械通气的临床疗效。方法:选取行机械通气治疗的COPD并呼吸衰竭患者72例,随机分为A组、B组、C组,每组24例。A组采用传统撤机方法,B组与C组分别在呼吸系统功能评分为3~4分,5~6分时撤机,比较3组患者撤机状况、机械通气时间、入住ICU时间及并发症发生率。结果:直接撤机成功率比较:B组>C组>A组(P<0.05);患者机械通气时间、入住ICU时间比较:B组<C组<A组(P<0.05);患者肺部气压伤、呼吸机相关性肺炎(VAP)发生率比较:B组<C组<A组(P<0.05)。结论:呼吸系统功能评分3~4分作为呼吸机撤机指标可缩短机械通气与入住ICU时间,降低VAP发生率,且不影响撤机成功率。更多还原

【Abstract】 Objective:To compare the clinical therapeutic effect of different weaning modes in the treatment of chronic obstructive pulmonary disease(COPD)with respiratory failure using invasive mechanical ventilation.Methods:A total of 72 COPD patients accompanied with respiratory failure were selected,all of them were treated with mechanical ventilation,and they were randomly divided into A,B and C group,24 cases in each group.Patients of A group were treated with ventilator weaning according to traditional method,patients of B and C group were treated with ventilator weaning when respiratory system function score was 3~4,5~6,respectively.Ventilator weaning results,including ventilator weaning status,duration of mechanical ventilation,ICU stay time and incidence of complications were compared.Results:Directly successful ventilator weaning rate:B grouP>C grouP>A group(P<0.05);Duration of mechanical ventilation and ICU stay time:B grouP<C grouP<A group(P<0.05);incidence of lung barotraumas and VAP:B grouP<C grouP<A group(P<0.05).Conclusion:Ventilator weaning when respiratory system function score is 3~4 can effectively shorten the duration of mechanical ventilation or ICU stays,reduce the incidence of VAP,without affecting successful ventilator weaning rate.更多还原