慢性阻塞性肺疾病伴呼吸衰竭患者的机械通气治疗与治疗延迟时间之研究.pdfVIP

· 1024· 急救医学2007年11月第27卷第11期 Chin J 丛 !． !： oJ． !： ：!! 厦性阻塞性肺疾病伴呼吸衰竭患者的机械通气 治疗与治疗延迟时间之研究 钟 松， 张连东 作者单位：201900，【 簿 山中心医院急诊 作者简介：钟 松(197l一)。男，主治医邮．j 婴从 救危重病研究。 通汛作者：张连东(1956一)，男，主任医帅，主要从：lf 牡危 病研究。 [摘要] 目的 探讨不同机械通气方式对慢性脚l毫性肺疾病(CO1 D)呼吸衰竭患者的治疗结 果与机械通气延迟治疗时间的关系。方法 对我院急诊科ICU收治的44例接受机械通气COPD 呼吸衰竭患者，根据机械通气方式分为无创通气组和有创通气组，进一步根据治疗结果分为无创成 功18例、无创失败4例、有创成功10例、有创失败12例，回顾性分析其临『末资料，观察不同情况下 接受机械通气的延迟时间。结果 无创通气组的APACHE lI评分值、延迟时间、严重并发症发生比 例、治疗失败比例低于有创通气组(P0．05)；同一种机械通气的治疗成功与失败者之问机械通气 延迟时间比较差异有统汁学意义(P0．05)。结论 不同机械通气方式之间的机械通气延迟时问 不同，机械通气延迟时间影响COPD伴呼吸衰竭患者治疗结果。 [关键词] 机械通气；慢性阻塞性肺疾病； 呼吸衰竭 [中图分类号] R 563．8 [文献标识码] B [文章编号] 1002—1949(2007)11～1024—03 Study on relationship between mechanical ventilation of COPD patients with respiratory failure and the delayed time of the treatment ZHONG Song，ZHANG Lian—dong．Emergency Department， Shanghai Baoshan Central Hospital，Shanghai 20 1 900，China [Abstract] 0bjective To explore the relationship between the mechanical ventilation for chronic obstructive puhnonary disease(COPD)patients with respirator failure and the delayed time of the treat— ment．Method In the emergency department and ICU during the past three years，44 cases of COPD pa— tients with respiratory failure were reviewed and divided into noninvasive ventilation group(success=1 8 cases。failure：4 cases)and invasive ventilation group(success：1 0 cases，failure：1 2 cases)．The delayed time of the mechanical ventilation were investigated．Result In the invasive ventilation group， APACHE 1I SCOldS，the delayed time，the ratio of severe complications and proportion of treatment failures were much higher than those in non—invasive ventilation gaoup(P0．05)；the delayed time of mechanical ventilation in failure patients was much higher than that in successful patients(P0．05)．Conclusion The delayed time of mechanical ventilation were different in the different mech