基础医学与临床
基礎醫學與臨床
기출의학여림상
Basic & Clinical Medicine
2015年
2期
224-227
,共4页
慢性阻塞性肺病%机械通气%有创通气%无创通气%撤机
慢性阻塞性肺病%機械通氣%有創通氣%無創通氣%撤機
만성조새성폐병%궤계통기%유창통기%무창통기%철궤
chronic obstructive pulmonary disease%mechanical ventilation%invasive mechanical ventilation%noninvasive ventila-tion%clinical weaning
目的：探讨有创-无创序贯撤机策略在慢性阻塞性肺病（ COPD）机械通气撤机困难患者中作用。方法选择2009年1月至2013年12月期间辽宁省葫芦岛市中心医院急诊科监护室慢性阻塞性肺病机械通气撤机困难患者45例，比较有创-无创序贯撤机（干预组，n＝21）与撤机拔管后立即给予鼻导管给氧（对照组，n＝24）两组间撤机后动脉血气（ pH、PaCO2）、48 h再气管插管率、撤机成功率。结果干预组撤机拔管24 h后pH、PaCO2明显优于对照组（ P＜0.01）；干预组48 h再气管插管率为9.5％，低于对照组41.7％（ P＜0.05），干预组再插管相对危险度0.147（95％CI，0.028～0.781）。干预组撤机成功率明显高于对照组（85.7％ vs 50.0％，P＜0.05）。结论撤机困难COPD患者有创-无创序贯撤机策略有助于降低48 h再气管插管率和提高撤机成功率。
目的：探討有創-無創序貫撤機策略在慢性阻塞性肺病（ COPD）機械通氣撤機睏難患者中作用。方法選擇2009年1月至2013年12月期間遼寧省葫蘆島市中心醫院急診科鑑護室慢性阻塞性肺病機械通氣撤機睏難患者45例，比較有創-無創序貫撤機（榦預組，n＝21）與撤機拔管後立即給予鼻導管給氧（對照組，n＝24）兩組間撤機後動脈血氣（ pH、PaCO2）、48 h再氣管插管率、撤機成功率。結果榦預組撤機拔管24 h後pH、PaCO2明顯優于對照組（ P＜0.01）；榦預組48 h再氣管插管率為9.5％，低于對照組41.7％（ P＜0.05），榦預組再插管相對危險度0.147（95％CI，0.028～0.781）。榦預組撤機成功率明顯高于對照組（85.7％ vs 50.0％，P＜0.05）。結論撤機睏難COPD患者有創-無創序貫撤機策略有助于降低48 h再氣管插管率和提高撤機成功率。
목적：탐토유창-무창서관철궤책략재만성조새성폐병（ COPD）궤계통기철궤곤난환자중작용。방법선택2009년1월지2013년12월기간요녕성호호도시중심의원급진과감호실만성조새성폐병궤계통기철궤곤난환자45례，비교유창-무창서관철궤（간예조，n＝21）여철궤발관후립즉급여비도관급양（대조조，n＝24）량조간철궤후동맥혈기（ pH、PaCO2）、48 h재기관삽관솔、철궤성공솔。결과간예조철궤발관24 h후pH、PaCO2명현우우대조조（ P＜0.01）；간예조48 h재기관삽관솔위9.5％，저우대조조41.7％（ P＜0.05），간예조재삽관상대위험도0.147（95％CI，0.028～0.781）。간예조철궤성공솔명현고우대조조（85.7％ vs 50.0％，P＜0.05）。결론철궤곤난COPD환자유창-무창서관철궤책략유조우강저48 h재기관삽관솔화제고철궤성공솔。
Objective To study the strategy of sequential invasive-noninvasive mechanical ventilation in chronic ob-structive pulmonary disease ( COPD ) and specially to explore the role of mechanical ventilation in patients with weaning difficulty .Methods Forty-five cases withe weaning difficulty during January 2009 ~December 2013 from Huludao central hospital emergency section guardianship room were recruited .Compare the rate of re-tracheal intu-bation rate and withdrawal machine success rate in two groups ( intervention group , n=21 , control group , n=24 ) . Results In the intervention group after weaning the 24 h pH, PaCO2 was significantly better than that of the control group ( P<0.01 ) ,in the endotracheal intubation intervention group ,48 h re-tracheal intubation rate was 9.5%, less than the control group ( 41.7%) (P<0.05), The relative risk of intervention group was 0.147 (95%CI, 0.028~0.781 ) .Intervention weaning success rate is significantly higher than that of the control group (85.7%vs 50.0%,P<0.05 ) .Conclusions Sequential invasive-noninvasive mechanical ventilation strategy reduces 48 h in-tubation rate and improve the success rate of weaning .
