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目的 :对 1987年～ 1998年 10月 ,使用呼吸机治疗衰竭的病例 ,进行回顾性分析。方法 :选择有详细病程纪录的 10 0 0例次患者 ,其中 型呼衰 5 74例 , 型呼衰 42 6例。原发病为外科疾病 694例 ,内科疾病113例 ,呼吸系统疾病 193例 ,平均使用时间 (3 .2± 1.7)天。在通气连接方式的选择上 ,清醒合作的病人 ,主要为 型或部分 型呼衰 ,采用无创鼻 (面 )罩连接通气 (Bi PAP) ,效果不佳者及时改用气管插管。 型呼衰病情允许时采用经鼻气管插管 ,紧急时采用经口插管 ,有些预计需较长时间行机械通气的患者 ,直接作气管切开。依据病情选定通气模式及撤机方式。结果 :10 0 0例机械通气患者 ,呼吸衰竭治疗有效者 987例 (98.7% ) ,治愈及好转率 92 .0 %。总死亡 80例 (8.0 % ) ,其中 67例呼衰虽有不同程度的纠正 ,但患者最终死于术后并发症或发原病 ,9例 (0 .9% )机械通气后仍因呼吸衰竭死亡。与机械通气有关造成的死亡 4例 (0 .4% ) ,机械通气相关并发症 14 7例次。结论 :在机械通气治疗过程中 ,必须强调床边护理、监测 ,将人工气道管理作为重点 ,床边常规备简易呼吸器。长时间机械通气常给患者带来一系列并发症和不利影响 ,所以 ,对患者是否应用呼吸机 ,采用何种连接方式 ,应根据患者具体情况和机械通气理论以?
OBJECTIVE: To retrospectively analyze the cases of respiratory failure treated by ventilator from 1987 to October 1998. Methods: One hundred and ten patients with a detailed history of the disease were selected, including 5 74 cases of middle-type respiratory failure and 426 cases of respiratory failure. The primary disease was 694 cases of surgical diseases, 113 cases of internal diseases and 193 cases of respiratory diseases, the average duration of use was (3.2 ± 1.7) days. Ventilation connection options, conscious cooperation of patients, mainly for type or partial respiratory failure, noninvasive nasal (face) cover ventilation (Bi PAP), ineffective timely tracheal intubation. Type respiratory failure when allowed by nasotracheal intubation, oral emergency intubation, and some are expected to be longer mechanical ventilation in patients with direct tracheotomy. According to the condition selected ventilation mode and weaning mode. Results: One hundred and ten patients with mechanical ventilation were treated 987% (98.7%) with effective treatment of respiratory failure. The cure and improvement rate was 92.0%. Of the total 80 deaths (8.0%), 67 cases of respiratory failure were corrected to some extent, but the patients eventually died of postoperative complications or hair root disease. However, 9 cases (0.9%) were still suffering from respiratory failure after mechanical ventilation death. Four deaths were associated with mechanical ventilation (0.4%), and 147 were mechanical ventilation-related complications. Conclusion: In the course of mechanical ventilation therapy, bedside care and monitoring must be emphasized, artificial airway management should be the focus, and bedside routine simple ventilator should be emphasized. Long-term mechanical ventilation often give patients a series of complications and adverse effects, so whether the application of ventilator patients, what kind of connection should be based on the specific circumstances of patients and mechanical ventilation theory?