检验医学与临床
檢驗醫學與臨床
검험의학여림상
Laboratory Medicine and Clinic
2015年
20期
3028-3030
,共3页
慢性阻塞性肺疾病%呼吸衰竭%机械通气%适应性压力支持通气
慢性阻塞性肺疾病%呼吸衰竭%機械通氣%適應性壓力支持通氣
만성조새성폐질병%호흡쇠갈%궤계통기%괄응성압력지지통기
chronic obstructive pulmonary disease%respiratory failure%mechanical ventilation%adaptive pressure support ventilation
目的：观察不同通气模式在慢性阻塞性肺疾病（COPD）急性加重合并呼吸衰竭患者中的临床效果，为临床治疗提供参考依据。方法收集临床诊断为COPD急性加重合并呼吸衰竭的患者26例，采用随机数字表法将其分为两组，每组各13例，分别为同步间歇指令性通气（SIM V ）＋压力支持通气（PSV ）模式组和适应性压力支持（ASV ）模式组，比较两组患者治疗前及治疗3 d后的体温、心率、呼吸频率及血气分析指标，比较两组患者的有创通气时间、呼吸机相关肺炎（VAP）的发生率、住院时间及不良反应发生情况。结果治疗后两组患者的心率、呼吸频率及血气分析指标与治疗前相比，差异均有统计学意义（P＜0．05）。ASV模式组患者的有创通气时间及住院时间均少于SIMV＋PSV模式组，差异有统计学意义（P＜0．05）。ASV模式组和SIMV＋PSV模式组的VAP发生率分别为7．7％、15．4％，总不良反应发生率分别为30．8％、38．6％，差异均无统计学意义（P＞0．05）。结论 ASV模式对COPD急性加重合并呼吸衰竭患者的临床效果较SIM V＋PSV模式好，推荐在临床上应用。
目的：觀察不同通氣模式在慢性阻塞性肺疾病（COPD）急性加重閤併呼吸衰竭患者中的臨床效果，為臨床治療提供參攷依據。方法收集臨床診斷為COPD急性加重閤併呼吸衰竭的患者26例，採用隨機數字錶法將其分為兩組，每組各13例，分彆為同步間歇指令性通氣（SIM V ）＋壓力支持通氣（PSV ）模式組和適應性壓力支持（ASV ）模式組，比較兩組患者治療前及治療3 d後的體溫、心率、呼吸頻率及血氣分析指標，比較兩組患者的有創通氣時間、呼吸機相關肺炎（VAP）的髮生率、住院時間及不良反應髮生情況。結果治療後兩組患者的心率、呼吸頻率及血氣分析指標與治療前相比，差異均有統計學意義（P＜0．05）。ASV模式組患者的有創通氣時間及住院時間均少于SIMV＋PSV模式組，差異有統計學意義（P＜0．05）。ASV模式組和SIMV＋PSV模式組的VAP髮生率分彆為7．7％、15．4％，總不良反應髮生率分彆為30．8％、38．6％，差異均無統計學意義（P＞0．05）。結論 ASV模式對COPD急性加重閤併呼吸衰竭患者的臨床效果較SIM V＋PSV模式好，推薦在臨床上應用。
목적：관찰불동통기모식재만성조새성폐질병（COPD）급성가중합병호흡쇠갈환자중적림상효과，위림상치료제공삼고의거。방법수집림상진단위COPD급성가중합병호흡쇠갈적환자26례，채용수궤수자표법장기분위량조，매조각13례，분별위동보간헐지령성통기（SIM V ）＋압력지지통기（PSV ）모식조화괄응성압력지지（ASV ）모식조，비교량조환자치료전급치료3 d후적체온、심솔、호흡빈솔급혈기분석지표，비교량조환자적유창통기시간、호흡궤상관폐염（VAP）적발생솔、주원시간급불량반응발생정황。결과치료후량조환자적심솔、호흡빈솔급혈기분석지표여치료전상비，차이균유통계학의의（P＜0．05）。ASV모식조환자적유창통기시간급주원시간균소우SIMV＋PSV모식조，차이유통계학의의（P＜0．05）。ASV모식조화SIMV＋PSV모식조적VAP발생솔분별위7．7％、15．4％，총불량반응발생솔분별위30．8％、38．6％，차이균무통계학의의（P＞0．05）。결론 ASV모식대COPD급성가중합병호흡쇠갈환자적림상효과교SIM V＋PSV모식호，추천재림상상응용。
Objective To observe the clinical effect of different modes of mechanical ventilation for acute exac‐erbation chronic obstructive pulmonary disease (COPD) patients combined with respiratory failure ,and to provide the reference for the clinical treatment .Methods 26 cases of COPD patients combined with respiratory failure were en‐rolled in the study ,and randomly divided into two groups :synchronized intermittent mandatory ventilation (SIMV)+pressure support ventilation (PSV) model group (n=13) and adaptive support ventilation (ASV) model group (n=13) .The body temperatures ,heart rates ,respiratory frequencies and blood gas analysis indexes of two groups were compared before treatment and 3 d after treatment ,respectively .The invasive mechanical ventilation times ,ventilator associated pneumonia (VAP) incidences ,length of hospital stay and adverse reaction rates of two groups were also compared .Results After treatment ,the heart rates ,respiratory frequencies and blood gas analysis indexes of two groups were significantly different with those before treatment (P<0 .05) .The invasive mechanical ventilation time and length of hospital stay of ASV model group were significantly shorter than those of SIMV + PSV model group (P<0 .05) .The VAP incidences of ASV model group and SIMV+PSV model group were 7 .7% and 15 .4% ,and the total adverse reaction rates of two group were 30 .8% and 38 .6% respectively ,with no significant difference (P>0 .05) .Conclusion The clinical effect of ASV model is better than SIMV+PSV model in the treatment of patients of acute exacerbation COPD combined with respiratory failure ,which is worthy of promotion .
