有创―无创机械序贯通气改善呼吸衰竭患者通气功能临床研究.docVIP

有创―无创机械序贯通气改善呼吸衰竭患者通气功能临床研究 　　[摘要]目的 探?有创-无创机械序贯通气改善呼吸衰竭患者通气功能的临床研究。方法 选取2014年1月～2016年12月我院收治的呼吸衰竭患者125例，按照通气方法分为观察组65例与对照组60例。观察组采用有创-无创机械序贯通气，对照组仅采用有创机械通气。比较两组撤机前PaO2、PaCO2、HR和RR变化，观察组患者拔管时和BiPAP 4 hPaO2、PaCO2、HR、RR变化，及两组有创机械通气时间、机械通气总时间、撤机成功率和入住ICU住院时间变化。结果 两组患者撤机前的PaO2、PaCO2、HR和RR比较，差异无统计学意义（P0.05）；观察组患者拔管时和BiPAP 4 hPaO2、PaCO2、HR、RR比较差异无统计学意义（P0.05）；观察组有创机械通气时间和机械通气总时间短于对照组，差异有统计学意义（P0.05）；观察组撤机成功率高于对照组，入住ICU住院时间短于对照组，差异均有统计学意义（P0.05）。结论 有创-无创机械序贯通气改善呼吸衰竭患者效果明显，可明显缩短有创机械通气时间和机械通气总时间，改善患者通气功能，具有重要研究意义。 　　[关键词]有创-无创机械序贯通气；呼吸衰竭；通气功能 　　[中图分类号] R563.8 [文献标识码] A [文章编号] 1674-4721（2017）11（b）-0029-03 　　[Abstract]Objective To investigate the clinical study on invasive and noninvasive mechanical sequential ventilation in improving ventilatory function in patients with respiratory failure.Methods 125 patients with respiratory failure who were admitted to our hospital from January 2014 to December 2016 were selected.According to the ventilation method，the patients were divided into the observation group （65 cases） and the control group （60 cases）.The observation group was given invasive and noninvasive mechanical sequential ventilation，and the control group was only given invasive mechanical ventilation.Changes of PaO2，PaCO2，HR and RR were compared between the two groups before weaning，and the changes of PaO2，PaCO2，HR and RR levels upon extubation and BiPAP 4 h were observed in the observation group.The changes of invasive mechanical ventilation time，total mechanical ventilation time，weaning success rate and length of admission to ICU were observed in both groups.Results PaO2，PaCO2，HR and RR were compared between the two groups before weaning，and the difference was not statistically significant（P0.05）；there was no statistically significant difference in PaO2，PaCO2HR，RR between upon extubation and at BiPAP 4 h in the observation group（P0.05）；the invasive mechanical ventilation time and total mechanical ventilation time in the observation group were shorter than those in