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目的比较以肺部感染控制窗和呼吸泵衰竭改善为切换时机进行有创-无创序贯性机械通气治疗重症肺炎患者的应用价值。方法重症肺炎并需进行机械通气患者60例均分为两组,A组实施常规气管插管有创机械通气,B组以肺部感染控制窗、呼吸泵衰竭改善为切换时机行序贯有创-无创机械通气。比较两组临床效果。结果 B组有创机械通气时间[(5.20±1.16)d vs.(7.13±1.83)d]和总住院时间[(12.90±2.89)d vs.(13.61±3.10)d]均短于A组、VAP发生率(19.10%vs.28.20%)低于A组(P<0.05);两组总机械通气时间、住ICU时间、再插管率和住院病死率相仿(P>0.05)。结论对重症肺炎并呼吸衰竭需机械通气患者,比较以肺部感染控制窗及以呼吸泵衰竭改善为切换时机行有创-无创序贯性机械通气治疗,呼吸泵衰竭改善为切换时机为更好的评价指标。
Objective To compare the application value of invasive and noninvasive sequential mechanical ventilation in the treatment of severe pneumonia in patients with pulmonary infection control window and respiratory failure. Methods Severe pneumonia and mechanical ventilation were required in 60 patients were divided into two groups, A group of conventional tracheal intubation with invasive mechanical ventilation, B group with pulmonary infection control window, respiratory failure to improve the switch when the opportunity to sequential invasive Non-invasive mechanical ventilation. The clinical effects of two groups were compared. Results The duration of mechanical ventilation (5.20 ± 1.16 d vs. 7.13 ± 1.83 d) and total hospital stay (12.90 ± 2.89 d vs. 13.61 ± 3.10 days) in group B were significantly shorter than those in group A The incidence of VAP (19.10% vs.28.20%) was lower than that of group A (P <0.05). The total duration of mechanical ventilation, ICU stay, reintubation and hospital mortality were similar in both groups (P> 0.05). Conclusion Severe pneumonia and respiratory failure require mechanical ventilation in patients with lung infection control window compared with the failure to improve the respiratory pump when the opportunity to set invasive - noninvasive sequential mechanical ventilation, respiratory failure to improve the switching time is better The evaluation index.