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1、序贯机械通气治疗82例COPD伴严重呼吸衰竭的效果观察序贯机械通气治疗82例COPD伴严重呼吸衰竭的效果观察中南大学湘雅医院林胡诺【摘要】1=1的：探讨序贯机械通气治疗慢性阻塞性肺疾病(COPD)合并严重呼吸衰竭患者的临床疗效。方法：选择我院2013年7月至2014年3月收治的82例COPD合并严重呼吸衰竭患者为研究对象，随机分为对照组41例，观察组41例，观察组行序贯机械通气治疗，对照组行持续有创机械通气治疗，对两组患者治疗后临床疗效及通气治疗指标进行分析。结果：观察组无创通气治疗前后的血气分析与PSV对比无明显差异(P
2、>0.05)；观察组有创通气治疗时间与入住RICU时间、住院费川等治疗指标均优于对照组，差异有统计学意义(PV0.05)。观察组VAP发生率为2.44%,再插管率2.44%。死亡率为2.44%,显著低于对照组VAP发生率29.27%,再插管率24.39%,死亡率14.63%,差异有统计学意义(P<0.05)。结论：对COPD伴严重呼吸衰竭患者采取序贯机械通气治疗效果显著，可缩短患者恢复时间，减少医疗费用，值得临床进一步推广使用。【关键词】序贯机械通气治疗；COPD；严重呼吸衰竭Effectobservationofsequ
3、entialmechanicalventilationinthetreatmentof82casesofCOPDwithsevererespiratoryfailure[Abstract]Objective：Toexploretheclinicalcurativeeffectofsequentialmechanicalventilationinthetreatmentofchronicobstructivepulmonarydisease(COPD)patientswithsevererespiratoryfailure.
4、Method：82casesofCOPDpatientswithsevererespiratoryfailureinourhospitalfromJuly2013toMarch2014wereselected,andweredividedintocontrolgroup(41cases)andobservationgroup(41cases)>Observationgroupweregivensequentialmechanicalventi1ationinthetreatment,controlgroupweregive
5、ncontinuousinvasivemechanicalventilationtreatment・Theclinicalefficacyandventilationinthetreatmentofindexaftertreatmentofthetwogroupswereanalysised.Results：TheobservationgroupcomparedwithnonbloodgasanalysisbeforeandafterPSVnon-invasiveventilationinthetreatmentofnos
6、ignificantdifference(P〉0.05);invasiveventilotiontimeandR1CUslaytime,costofhospitalizationtreatmentoftheobservationgroupforwerebetterthanthecontrolgroup,thedifferencewassteitisticallysignificant(P<0.05).TheobservationgrouptheincidenceofVAPwas2.44%,reintubationratew
7、as2.44%.Themortalityratewas2.44%,significantlylowerthanthecontrolgroup,theincidcncerateofVAPwas29.27%,reintubationratewas24.39%,mortalityratewas14.63%,thedifferencewasstatisticallysignificant(P<0・05).Conclusion：Theeffectontheuseofsequentialmechanicalventilationint
8、hetreatmentofpatientswithsevererespiratoryfailurewithCOPDissignificant,itcanshortentherecoverytimeofpatients,andreducethemedicalcost,itisworthyoffurther
