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目的 了解小潮气量联合低水平呼吸末正压通气 (PEEP)机械通气治疗慢性阻塞性肺疾病(COPD)呼衰并肺大泡的疗效及安全性。方法 48例COPD呼衰并肺大泡的病人随机分为常规通气组 2 3例和小潮气量联合低水平PEEP通气组 2 5例 ,比较两组的通气时间、气压伤发生率及死亡率。结果 小潮气量联合低水平PEEP组气压伤的发生率显著低于常规通气组 ,通气时间也显著小于常规通气组 ,死亡率的比较两组间差异无显著意义。结论 小潮气量联合低水平PEEP机械通气治疗COPD呼衰并肺大泡可显著减少病人气压伤的发生率和缩短通气时间 ,减少病人的精神、经济负担 ,值得临床推广应用
Objective To investigate the efficacy and safety of mechanical ventilation with low tidal volume combined with low-level positive end-expiratory pressure ventilation (PEEP) in the treatment of chronic obstructive pulmonary disease (COPD) and pulmonary bullae. Methods Forty-eight COPD patients with COPD and pulmonary bullae were randomly divided into routine ventilation group (n = 23) and low tidal volume combined with low PEEP group (n = 25). Ventilation time, incidence of barotrauma and mortality were compared between the two groups. Results The incidence of barotrauma in low tidal volume combined with low level PEEP group was significantly lower than that in routine ventilation group and ventilation time was significantly lower than that in routine ventilation group. There was no significant difference in mortality between the two groups. Conclusions Low tidal volume combined with low level PEEP mechanical ventilation can significantly reduce the incidence of barotrauma and pulmonary bullae in patients with COPD and shorten the ventilation time, reduce the patient’s mental and financial burden, and worthy of clinical application