發(fā)布時(shí)間：2018-04-03 17:08

  本文選題：慢性阻塞性肺疾病　切入點(diǎn)：適應(yīng)性支持通氣　出處：《中國(guó)老年學(xué)雜志》2016年01期

【摘要】：目的比較閉環(huán)通氣模式適應(yīng)性支持通氣(ASV)與自主呼吸實(shí)驗(yàn)(SBT)兩種脫機(jī)方法對(duì)慢性阻塞性肺疾病(COPD)患者機(jī)械通氣脫機(jī)的療效。方法將60例需要接受機(jī)械通氣的COPD患者納入觀察。按隨機(jī)數(shù)字法分為ASV組(30例)和SBT組(30例)進(jìn)行脫機(jī),記錄兩組患者年齡、性別、基礎(chǔ)疾病、入重癥醫(yī)學(xué)科時(shí)急性生理慢性健康狀況評(píng)分(APACHE)Ⅱ及脫機(jī)前機(jī)械通氣時(shí)間、血?dú)夥治龅戎笜?biāo)。兩組患者除撤機(jī)方法不同外,其他處理均相同,統(tǒng)計(jì)兩組患者的脫機(jī)時(shí)間、總機(jī)械通氣時(shí)間、脫機(jī)成功率、再插管率以及ICU住院時(shí)間、住ICU病死率。脫機(jī)成功標(biāo)準(zhǔn)為脫機(jī)拔管48 h以上未再進(jìn)行機(jī)械通氣。結(jié)果 ASV組的脫機(jī)時(shí)間、總機(jī)械通氣時(shí)間少于SBT組(P=0.000 1、P=0.000 5),但重癥醫(yī)學(xué)科住院時(shí)間與SBT組比較無(wú)差異(P=0.283)。脫機(jī)成功率及脫機(jī)48 h后接受無(wú)創(chuàng)通氣率兩組間無(wú)差異(P=0.222、P=0.765),再插管率兩組間無(wú)差異(P=0.687)。重癥醫(yī)學(xué)科住院病死率和總住院病死率兩組間比較無(wú)差異(P=0.553、0.640)。結(jié)論可以通過(guò)閉環(huán)通氣模式對(duì)COPD患者進(jìn)行脫機(jī),適應(yīng)性支持通氣模式可能略優(yōu)于自主呼吸實(shí)驗(yàn)法,但仍需要大樣本、多中心的前瞻性對(duì)照研究加以驗(yàn)證。
[Abstract]:Objective to compare the efficacy of closed loop ventilation (ASV) and automatic respiratory test (SBT) for mechanical ventilation weaning in patients with chronic obstructive pulmonary disease (COPD).Methods 60 COPD patients who needed mechanical ventilation were observed.ASV group (n = 30) and SBT group (n = 30) were divided into two groups according to random numerical method. Age, sex, basic disease, acute physiological chronic health status score (Apache) 鈪，

本文編號(hào)：1706127