机械通气SIMV模式-内科急危重症杂志.DOC

机械通气联合纳洛酮治疗慢性阻塞性肺疾病合并呼吸衰竭的疗效观察 林书生 赵开萌 张 炜 高 勃 淮安市淮安医院ICU（江苏 淮安，223200） 林书生，男，1970年出生，江苏淮安人，汉族，副主任医师，学士学位，从事重症监护治疗。联系地址：江苏省淮安市淮安区镇淮楼东路161号，淮安市淮安医院ICU。邮编：223200 【摘要】 目的 观察机械通气联合纳洛酮治疗慢性阻塞性肺疾病（简称慢阻肺）并发呼吸衰竭的疗效。方法 选择在我院ICU予有创机械通气治疗的慢阻肺并发呼吸衰竭患者73例，视是否使用纳洛酮分为治疗组和对照组，观察治疗前及治疗24h后血气指标、呼吸频率、心率、无创血压、5天内有效脱机率、有创机械通气时间、住ICU时间、7日病死率和28日病死率。结果 两组患者间pH、PO2、PCO2、呼吸频率、心率、血压等均无明显差异，治疗组有效脱机率明显增高（88.57%vs68.42%，p＜0.01），机械通气时间（2.93±1.05d vs 4.76±4.45d）、住ICU时间（5.17±2.12d vs 7.42±5.67d）明显缩短（p＜0.05），7日病死率（2.86% vs 13.16%，p＜0.05）和28日病死率（14.29% vs 34.21%，p＜0.05）明显降低，与对照组比较有统计学差异。结论 机械通气联合纳洛酮治疗慢阻肺并发呼吸衰竭可以提高有效脱机率，缩短机械通气时间和住ICU时间，降低病死率。 【关键词】机械通气；纳洛酮；慢性阻塞性肺疾病；呼吸衰竭 Observe of clinical effect of mechanical ventilation combined with naloxone in the treatment of patients with Chronic obstructive pulmonary disease combined with respiratory failure Lin shu-Sheng，Zhao kai-meng，Zhang Wei，Gao Bo． Intensive Care Unit Department ，Huaian Hospital of Huaian City， Huaian 223200，Jiangsu，China． Corresponding：Lin Shu-sheng， [Abstract] Objective To observe the effect of mechanical ventilation combined with naloxone in the treatment of patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods 73 patients with COPD complicated with respiratory failure divided into combined naloxone group which was given mechanical ventilation combined with naloxone and mechanical ventilation group which was given only mechanical ventilation. The clinical effect was observed and compared between the two groups. Results There were no significant differences between the two groups of patients at blood gas analysis, respiratory rate, heart rate, blood pressure. The rate of stop using mechanical ventilation was significantly higher in combined naloxone group than mechanical ventilation group (88.57%vs68.42%, P 0.01). The combined naloxone group were significantly shorten the duration of the mechanical ventilation (2.93 ± 1.05dvs4.76 ± 4.45d