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[目的]研究有创-无创序贯机械通气治疗重症呼吸衰竭的方法与疗效。[方法]分为序贯通气组和对照组。达到肺部感染控制窗(PIC)后,给予两组不同的后续治疗,观察两组患者有创通气时间、呼吸机相关肺炎(VAP)发病率等指标。[结果]序贯组与对照组发生VAP例数分别为1例(5%)和7例(29%),总机械通气时间分别为(9.7±3.1)d和(16.9±3.7)d,住院时间分别为(15.7±3.7)d和(23.5±3.6)d,2组各项指标比较差异均有统计学意义(P﹤0.05)。[结论]在PIC窗指导下的有创-无创序贯通气治疗,能够显著减少机械通气时间,降低VAP发生率,缩短重症监护和总住院时间,改善治疗效果,降低治疗费用,提高抢救成功率。
[Objective] To study the methods and efficacy of invasive-non-invasive sequential mechanical ventilation in the treatment of severe respiratory failure. [Methods] divided into sequential ventilation group and control group. After reaching the control window of pulmonary infection (PIC), two groups of different follow-up treatment were given. The duration of invasive ventilation and the incidence of ventilator-associated pneumonia (VAP) were observed. [Results] The incidence of VAP in sequential group and control group were 1 case (5%) and 7 cases (29%), respectively. The total duration of mechanical ventilation was (9.7 ± 3.1) days and (16.9 ± 3.7) days, respectively. The time was (15.7 ± 3.7) d and (23.5 ± 3.6) d respectively. There was significant difference between the two groups (P <0.05). [Conclusion] The invasive and noninvasive sequential ventilation guided by PIC window can significantly reduce the time of mechanical ventilation, reduce the incidence of VAP, shorten the intensive care and total hospital stay, improve the treatment effect, reduce the treatment cost, and improve the success rate of rescue .