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目的:探讨序贯机械通气在慢性阻塞性肺疾病(COPD)合并呼吸衰竭中的应用价值。方法:收集2011年4月至2013年2月广东省揭阳市人民医院收治的40例COPD合并呼吸衰竭的患者作为研究对象,随机分为序贯组(序贯机械通气)和传统组(有创机械通气),每组20例。比较两组生命体征、血气分析、呼吸机参数、呼吸机相关性肺炎发生率、死亡率、有创机械通气时间、住ICU时间、住院费用等指标。结果:两组患者生命体征、血气分析、呼吸机参数比较,差异无统计学意义(P>0.05)。序贯组有创机械通气时间、ICU入住时间、住院费用、呼吸机相关性肺炎发生率、死亡率均少于传统组(P<0.05)。结论:对于COPD合并严重呼吸衰竭,序贯机械通气可降低呼吸机相关性肺炎发生率和死亡率下降,缩短有创机械通气时间、ICU入住时间,减少住院费用,是较好的机械通气策略。
Objective: To investigate the value of sequential mechanical ventilation in chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods: Forty COPD patients with respiratory failure who were admitted to Jieyang People’s Hospital of Guangdong Province from April 2011 to February 2013 were randomly divided into sequential group (sequential mechanical ventilation) and conventional group Mechanical ventilation), 20 cases in each group. Comparisons of vital signs, blood gas analysis, ventilator parameters, ventilator-associated pneumonia incidence, mortality, invasive mechanical ventilation time, ICU stay, hospitalization costs and other indicators were compared. Results: There were no significant differences in vital signs, blood gas analysis and ventilator parameters between the two groups (P> 0.05). Sequential group of invasive mechanical ventilation time, ICU admission time, hospitalization costs, ventilator-associated pneumonia incidence and mortality were less than the traditional group (P <0.05). CONCLUSIONS: Sequential mechanical ventilation can reduce the incidence and mortality of ventilator-associated pneumonia and shorten the duration of invasive mechanical ventilation, ICU admission and hospitalization for COPD with severe respiratory failure. It is a good mechanical ventilation strategy.