| 摘要: |
| ［摘要］ 目的 观察有创无创序贯机械通气抢救重症老年呼吸衰竭患者的有效性与安全性。方法 选取2008-01～2015-01该院接受机械通气治疗的重症呼吸衰竭老年患者90例，根据机械通气方案的不同分为研究组与对照组各45例，分别进行有创无创序贯机械通气及持续有创机械通气。观察两组患者呼吸及血气指标、应激反应程度、临床效果等。结果 研究组撤机成功率、呼吸机相关性肺炎、再插管率、病死率明显低于对照组（P<0.05）；研究组心率、呼吸、pH值、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、动脉血氧饱和度（SaO2）明显优于对照组（P<0.01）；研究组肾上腺素（E）、去甲肾上腺素（NE）、肾素（R）、血管紧张素（AT）II水平与对照组比较差异有统计学意义（P<0.05）；研究组患者的总机械通气时间、住院时间、有创通气时间、住ICU时间、胸片征象消失时间、氧合指数（PaO2/FiO2）恢复正常时间均明显短于对照组，住院费用少于对照组，差异均有统计学意义（P<0.01）。结论 有创无创序贯机械通气抢救重症老年呼吸衰竭患者，具有较好的临床效果，并发症少，病死率低，值得推广。 |
| 关键词: 呼吸衰竭 安全性 有创无创序贯机械通气 |
| DOI：10.3969/j.issn.1674-3806.2016.02.15 |
| 分类号:R 563.8 |
| 基金项目: |
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| The effectiveness and safety of noninvasive sequential mechanical ventilation in the treatment of severe respiratory failure in elderly patients |
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LI Hong-jian
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Department of Respiratory Medicine, Shan County Central Hospital, Shandong 274300, China
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| Abstract: |
| ［Abstract］ Objective To observe the effectiveness and safety of noninvasive mechanical ventilation in the treatment of severe respiratory failure in elderly patients.Methods Ninety patients with severe respiratory failure treated with mechanical ventilation were divided into the study group and the control group according to the different mechanical ventilation schemes. The study group was conducted with noninvasive sequential mechanical ventilation, while the control group received invasive mechanical ventilation. The blood gas, the clinical effect and the degree of stress reaction were compared between the two groups.Results The success rate of ventilator weaning, ventilator-associated pneumonia, reintubation rate and mortality rate were significantly lower in the study group than those in the control group, with significant differences between the two groups(P<0.05); The heart rate, respiration, pH, PaO2, PaCO2, SaO2 in the study group improved significantly better than those in the control group(P<0.05); There were significant differences in adrenaline(E), norepinephrine(NE), renin(R), angiotensin(AT) and angiotensin-Ⅱ levels between the study group and the control group(P<0.05). The total mechanical ventilation time, the hospitalization time, the duration of ventilation, the length of stay in ICU, the sternum sign disappeared time, and the time of PaO2/FiO2 were shorter in the study group than in the control group(P<0.05); The average hospitalization cost of the study group was significantly less than that of the control group(P<0.05).Conclusion Noninvasive sequential mechanical ventilation has a better clinical effect and a lower mortality rate in the treatment of severe respiratory failure. |
| Key words: Respiratory failure Safety Noninvasive sequential mechanical ventilation |
