中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
10期
1176-1177
,共2页
肺疾病,慢性阻塞性%序贯机械通气%呼吸衰竭
肺疾病,慢性阻塞性%序貫機械通氣%呼吸衰竭
폐질병,만성조새성%서관궤계통기%호흡쇠갈
Pulmonary disease,chronic obstructive%Sequential therapy of mechanical ventilation%Respiratory failure
目的 探讨慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭，无创正压机械通气(NIPPV)有效但不能长时间耐受时，呼吸机治疗方式的选择。方法 将43例无创正压机械通气( NIPPV)有效但不能长时间耐受的COPD合并Ⅱ型呼吸衰竭患者随机分为传统机械通气组（对照组，25例）和序贯机械通气组（研究组，18例）。对照组患者继续给予NIPPV,无效后再改为有创机械通气(IPPV)；研究组患者给予IPPV，根据病情早期脱机，序贯以NIPPV。比较2组患者最终的病死率、平均住院时间和平均住院费用。结果 对照组21例好转出院，4例死亡，病死率为16.0％；平均住院时间(16.6 ±4.9)d，平均住院费用(50 766 ±21 082)元。研究组17例好转出院，1例死亡，病死率为5.5％；平均住院时间(13.7±5.1)d，平均花费(78 576±25 540)元。2组比较，研究组病死率低于对照组，平均住院费用高于对照组，平均住院时间少于对照组，差异均有统计学意义(P＜0.05)。结论 对于COPD合并Ⅱ型呼吸衰竭，NIPPV有效但不能长时间耐受的患者，序贯机械通气治疗病死率和住院时间明显低于传统机械通气治疗，但住院费用更高。
目的 探討慢性阻塞性肺疾病(COPD)閤併Ⅱ型呼吸衰竭，無創正壓機械通氣(NIPPV)有效但不能長時間耐受時，呼吸機治療方式的選擇。方法 將43例無創正壓機械通氣( NIPPV)有效但不能長時間耐受的COPD閤併Ⅱ型呼吸衰竭患者隨機分為傳統機械通氣組（對照組，25例）和序貫機械通氣組（研究組，18例）。對照組患者繼續給予NIPPV,無效後再改為有創機械通氣(IPPV)；研究組患者給予IPPV，根據病情早期脫機，序貫以NIPPV。比較2組患者最終的病死率、平均住院時間和平均住院費用。結果 對照組21例好轉齣院，4例死亡，病死率為16.0％；平均住院時間(16.6 ±4.9)d，平均住院費用(50 766 ±21 082)元。研究組17例好轉齣院，1例死亡，病死率為5.5％；平均住院時間(13.7±5.1)d，平均花費(78 576±25 540)元。2組比較，研究組病死率低于對照組，平均住院費用高于對照組，平均住院時間少于對照組，差異均有統計學意義(P＜0.05)。結論 對于COPD閤併Ⅱ型呼吸衰竭，NIPPV有效但不能長時間耐受的患者，序貫機械通氣治療病死率和住院時間明顯低于傳統機械通氣治療，但住院費用更高。
목적 탐토만성조새성폐질병(COPD)합병Ⅱ형호흡쇠갈，무창정압궤계통기(NIPPV)유효단불능장시간내수시，호흡궤치료방식적선택。방법 장43례무창정압궤계통기( NIPPV)유효단불능장시간내수적COPD합병Ⅱ형호흡쇠갈환자수궤분위전통궤계통기조（대조조，25례）화서관궤계통기조（연구조，18례）。대조조환자계속급여NIPPV,무효후재개위유창궤계통기(IPPV)；연구조환자급여IPPV，근거병정조기탈궤，서관이NIPPV。비교2조환자최종적병사솔、평균주원시간화평균주원비용。결과 대조조21례호전출원，4례사망，병사솔위16.0％；평균주원시간(16.6 ±4.9)d，평균주원비용(50 766 ±21 082)원。연구조17례호전출원，1례사망，병사솔위5.5％；평균주원시간(13.7±5.1)d，평균화비(78 576±25 540)원。2조비교，연구조병사솔저우대조조，평균주원비용고우대조조，평균주원시간소우대조조，차이균유통계학의의(P＜0.05)。결론 대우COPD합병Ⅱ형호흡쇠갈，NIPPV유효단불능장시간내수적환자，서관궤계통기치료병사솔화주원시간명현저우전통궤계통기치료，단주원비용경고。
Objective To investigate the respiratory therapy when noninvasive positive pressure ventilation (NIPPV) is effective but intolerant in chronic obstructive pulmonary disease(COPD) with type Ⅱ respiratory failure. Methods Forty-three COPD patients with respiratory failure, to whom NIPPV was effective but intolerant,were divided randomly into control(n =25) and treatment group( n = 18). The control group patients were treated sequentially by NIPPV. The treatment was replaced by invasive positive pressure ventilation (IPPV) when NIPPV was ineffective. The treatment group patients were treated by IPPV. Based on patients condition, IPPV was early weaned and patients were treated sequentially by NIPPV. Mortality, the average hospital cost and the average hospital days were compared after the treatment. Results In the 25 cases of the control group, 21 cases recovered and 4 cases died. The mortality was 16.0％. The average hospital cost was 50 766 ±21 082 CNY and the average hospital days were (16.6 ±4.9)d. In the 18 cases of the treatment group, 17 cases recovered and 1 case died. The mortality is 5.5％. The average hospital cost was 78 576 ±25 540 CNY and the average hospital days were (13.7 ±5.1)d.The mortality of the treatment group was lower than that of the control group; the average hospital days of the treatment group was lower than those of the control group; the average hospital cost of the treatment group was higher than that of the control group. Conclusions When NIPPV is effective but intolerant to COPD with type Ⅱ respiratory failure, the mortality of the sequential mechanical ventilation is lower than that of the conventional mechanical ventilation. Sequential mechanical ventilation has less hospital days but more hospital cost.
