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1、纤维支气管镜联合机械通气序贯治疗老年COPD严重呼吸衰竭的临床研究[摘要]目的探讨纤维支气管镜联合机械通气序贯治疗老年COPD严重呼吸衰竭的临床效果。方法选择我科收治的116例老年COPD严重呼吸衰竭患者,随机分为纤维支气管镜联合机械通气序贯治疗组(简称观察组)以及单纯机械通气序贯治疗组(简称对照组),每组各58例。观察两组患者的临床疗效,机械通气治疗后的相关指标以及切换时间窗时的血气分析指标。结果观察组患者有效率84.48%,优于对照组有效率70.69%,差异具有统计学意义(P〈0.05)。与对照组比较,观察组的有创机械通气时
2、间、总机械通气时间、呼吸衰竭纠正时间、感染控制窗出现时间、住院时间以及PaC02均降低明显,Pa02和pH值则升高明显,差异具有统计学意义(P〈0.05)。结论纤维支气管镜联合机械通气序贯治疗老年COPD严重呼吸衰竭,可有效改善患者临床症状,缩短机械通气时间,提高疗效,具有临床推广价值。[关键词]COPD;呼吸衰竭;纤维支气管镜;机械通气;序贯治疗;老年;临床研究[中图分类号]R563.3[文献标识码]B[文章编号]2095-0616(2014)16-161-03Clinicalanalysisoftreatedwithseni
3、leCOPDsevererespiratoryfailurebybranchofiberoscopecombinedwithsequentialmechanicalventilationWANGWenbinCHENJiemingDepartmentofCriticalCareMedicine,theSecondPeople,sHospitalofBaoanDistrict,Shenzhen518100,China[Abstract]ObjectiveTodiscussclinicaleffectoftreatedwithseni
4、leCOPDsevererespiratoryfailurebybranchofiberoscopecombinedwithsequentialmechanicalventilation.MethodsSelected116casessenileCOPDsevererespiratoryfailurepatientswhoweretreatedinourdepartment,randomlydividedthemintobranchofiberoscopecombinedwithsequentialmechanicalventi
5、lationtreatmentgroup(shortforobservationgroup)andsimplesequentialmechanicalventilationtreatmentgroup(shortforcontrolgroup),58casesineachgroup.Twogrouppatients'clinicalcurativeeffectswereobserved.Aftertreatedbymechanicalventilation,relevantindexesandtheindexofbloodgas
6、analysiswhenswitchtimewindowwereobserved.ResultsObservationgrouppatients'effectiveratewas84.48%,betterthancontrolgroup"s70.69%,thedifferenceshadstatisticalsignificances(P<0.05)・Comparedwithcontrolgroup,observationgroup"sinvasivemechanicalventilationtime,totalmechanic
7、alventilationtime,correctingrespiratoryfailuretime,infectioncontrolwindowappeartime,hospitallengthofstayandPaC02allobviouslydecreased,Pa02andpHvaluesallobviouslyincreased,thedifferenceshadstatisticalsignificances(P<0.05).ConclusionTreatedwithsenileCOPDsevererespirato
8、ryfailurebybranchofiberoscopecombinedwithsequentialmechanicalvent订ationcaneffectivelyimprovepatients,clinicalsymptoms,shortenmechan