CAJ | 학술논문

目的探讨微创经皮扩张气管切开行有创- 无创序贯机械通气疗法的临床优势. 方法随机选取2012年8月—2014年10月慢性阻塞性肺疾病患者60例,将患者分为两组,序贯治疗组,在有创机械通气后序贯进行无创机械通气,对照组,有创通气直至脱机,观察两组病例的感染、通气时间、ICU住院时间. 结果治疗组和对照组比较,有创机械通气时间分别为(6.3±2.9)d 和 (13.8±9.5)d (P<0.05),总机械通气时间分别为(8.1±3.4)d 和 (13.8±9.5)d (P<0.05),呼吸机相关性肺炎发生例数分别为0例和5例(P<0.05),ICU住院时间(9.3±3.1)d 和 (15.5±7.1)d (P<0.05). 结论慢性阻塞性肺疾病急性发作进行有创- 无创序贯机械通气可大大降低有创通气的时间及总的机械通气,缩减了VAP 的发生率,减少了住ICU 的时长.
목적 탐토미창경피확장기관절개행유창- 무창서관궤계통기요법적림상우세. 방법 수궤선취2012년8월—2014년10월만성조새성폐질병환자60례,장환자분위량조,서관치료조,재유창궤계통기후서관진행무창궤계통기,대조조,유창통기직지탈궤,관찰량조병례적감염、통기시간、ICU주원시간. 결과 치료조화대조조비교,유창궤계통기시간분별위(6.3±2.9)d 화 (13.8±9.5)d (P<0.05),총궤계통기시간분별위(8.1±3.4)d 화 (13.8±9.5)d (P<0.05),호흡궤상관성폐염발생례수분별위0례화5례(P<0.05),ICU주원시간(9.3±3.1)d 화 (15.5±7.1)d (P<0.05). 결론 만성조새성폐질병급성발작진행유창- 무창서관궤계통기가대대강저유창통기적시간급총적궤계통기,축감료VAP 적발생솔,감소료주ICU 적시장.
Objective To discuss the advantage of minimally invasive percutaneous dilational tracheostomy and invasive-noninva-sive sequential mechanical ventilation in the treatment of acute exacerbation chronic obstructive pulmonary disease. Methods 60 patients with chronic pulmonary disease between August 2012 and October 2014 were divided into two groups. The sequential therapy group was treated with invasive-noninvasive sequential mechanical ventilation, while the control group underwent invasive mechanical ventilation from start to finish. Time of pulmonary infection control window, duration of mechanical ventilation, and length of ICU stay were compared between the two groups. Results The duration of invasive mechanical ventilation was (6.3±2.9) d in the sequential therapy group and (13.8±9.5) d in the control group, P<0.05; the duration of overall mechanical ventilation was (8.1±3.4) d in the sequential therapy group and (13.8±9.5) d in the control group, P<0.05. No ventilator-associated pneumonia was found in the sequential therapy group but 5 cases in the control group. The lengthy of ICU stay was (9.3 ±3.1) d in the sequential therapy group and (15.5±7.1) d in the control group, P<0.05. Conclusion Invasive-noninvasive sequential mechanical ventilation in the treatment of acute exacerbation chronic obstructive pulmonary disease can significantly reduce the duration of invasive me-chanical ventilation and overall mechanical ventilation, lower the ventilator-associated pneumonia rate, and shorten the lengthy of ICU stay.