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目的探讨给予重症间质性肺疾病合并呼吸衰竭患者机械通气的疗效。方法选取长葛市妇幼保健院2011年11月—2015年2月收治的52例重症间质肺疾病合并呼吸衰竭患者作为本文探讨对象,按照机械通气治疗的不同分为无创组和有创组,接受无创机械通气治疗患者32例,有创机械治疗患者20例,对比两组疗效。结果引起重症间质性肺疾病并发呼吸衰竭的原因包括肺栓塞、单纯感染、呼吸道感染、心力衰竭以及疾病急性加重等;接受有创呼吸治疗的患者病死率为75.0%(15/20),接受无创机械通气患者病死率为43.8%(14/32),两组患者比较差异具有统计学意义(P<0.05)。两组在治疗前的HR、RR、PH、Pa O2以及Pa CO2水平与对照组无统计学意义(P>0.05),而在治疗后,无创组HR、RR、Pa O2以及Pa CO2水平均显著优于有创组,两组对比,差异有统计学意义(P<0.05)。结论肺栓塞、呼吸道感染、心力衰竭及间质性肺疾病严重程度是引起间质性肺疾病出现呼吸衰竭的主要原因;无创机械通气在治疗重症间质性肺疾病并发呼吸衰竭患者方面临床效果优于有创呼吸通气。
Objective To investigate the effect of mechanical ventilation on patients with severe interstitial lung disease complicated with respiratory failure. Methods 52 patients with severe interstitial lung disease and respiratory failure who were treated in Changge Maternal and Child Health Hospital from November 2011 to February 2015 were selected as the object of this study and divided into non-invasive group and invasive group according to different mechanical ventilation treatment. 32 patients underwent noninvasive mechanical ventilation and 20 patients underwent invasive mechanical ventilation. The curative effect was compared between the two groups. Results The causes of severe interstitial lung disease complicated with respiratory failure included pulmonary embolism, simple infection, respiratory infection, heart failure and acute exacerbation of disease. The mortality of patients receiving invasive respiratory therapy was 75.0% (15/20) The mortality rate of non-invasive mechanical ventilation was 43.8% (14/32). There was significant difference between the two groups (P <0.05). The HR, RR, PH, Pa O2 and Pa CO2 levels in the two groups before treatment were not significantly different from those in the control group (P> 0.05). However, HR, RR, Pa O2 and Pa CO2 levels were significantly higher in the non-invasive group Compared with invasive group, the difference between the two groups was statistically significant (P <0.05). Conclusions The severity of pulmonary embolism, respiratory tract infection, heart failure and interstitial lung disease are the main causes of respiratory failure in interstitial lung disease. The clinical effect of non-invasive mechanical ventilation in treating patients with severe interstitial lung disease complicated with respiratory failure is superior Invasive respiratory ventilation.