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目的 :评价面罩机械通气治疗慢性阻塞性肺疾病 (COPD)所致单纯急性呼吸衰竭的治疗效果及应用价值。方法 :选择接受机械通气的因慢性阻塞性肺疾病 (COPD)所致单纯急性呼吸衰竭病例 13例。其中 7例应用面罩机械 (PSV或A C)通气 ;另外 6例作为对照组 ,建立人工气道 ,行有创机械通气 ,并以PSV或PSV +SIMV方式撤机。动态观察两组病例的通气及氧合指标 ,总机械通气时间 ,住院天数及呼吸机相关肺炎的发生情况。结果 :两组的治疗效果相仿 (P >0 .0 5 )。无创与有创总机械通气时间分别为 ( 5 .6± 1.2 )和 ( 10 .0± 3)d(P <0 .0 5 ) ;住院时间分别为 ( 14± 5 )和 ( 2 4± 11)d(P <0 .0 1) ;呼吸机相关肺炎发生例数分别为 0和 3例 (P <0 .0 1)。结论 :经面罩机械通气治疗慢性阻塞性肺疾病 (COPD)所致单纯急性呼吸衰竭不但具有操作简单、使用方便、病人痛苦小、易接受、不良反应少等优点 ,而且疗效确切、缩短了住院时间、节约了费用 ,可作为首选方法使用。而建立人工气道有创机械通气应作为必要的补充。
Objective: To evaluate the therapeutic effect and application value of mask mechanical ventilation on acute respiratory failure caused by chronic obstructive pulmonary disease (COPD). Methods: Thirteen patients with acute respiratory failure due to chronic obstructive pulmonary disease (COPD) who underwent mechanical ventilation were enrolled. Seven of them were ventilated with mask machine (PSV or AC), and the other 6 as control group. The artificial airway was established, and mechanical ventilation was performed. The patients were weaned with PSV or PSV + SIMV. Ventilation and oxygenation indicators, total mechanical ventilation time, length of hospital stay and ventilator-associated pneumonia were dynamically observed in both groups. Results: The treatment effect was similar between the two groups (P> 0.05). The total duration of noninvasive and invasive mechanical ventilation was (5 .6 ± 1.2) days and (10 .0 ± 3) days (P <0.05), and the length of hospital stay was (14 ± 5) and (24 ± 11) ) d (P <0.01). The number of ventilator-associated pneumonia cases was 0 and 3 (P <0.01), respectively. Conclusion: The treatment of simple acute respiratory failure caused by chronic obstructive pulmonary disease (COPD) by mechanical ventilation of the mask not only has the advantages of simple operation, easy to use, little pain, easy to accept and few adverse reactions, but also curative effect and shortened hospital stay , Save money, can be used as the preferred method. The establishment of artificial airway invasive mechanical ventilation should be used as a necessary supplement.