机械辅助排痰结合体位引流对患者机械通气期间治疗效果的影响

发布时间：2019-01-10 09:13

【摘要】：目的探讨机械辅助排痰结合体位引流与常规叩背吸痰对慢性阻塞性肺疾病急性发作(AECOPD)患者机械通气脱机的影响。方法60例需要接受机械通气的AECOPD患者用随机数字法分为机械辅助排痰结合体位引流组(治疗组,30例)和常规叩背吸痰组(对照组,30例),治疗组使用机械排痰机结合体位引流治疗,对照组采用人工叩背结合体位引流。分别记录两组年龄、性别、既往基础疾病、急性生理与慢性健康状况评分(APACHE)Ⅱ以及脱机前机械通气时间等指标。两组患者除排痰方法不同外,其他处理均相同,统计两组患者治疗后的排痰量、氧分压(Pa O_2)、二氧化碳分压(Pa CO_2)、气道阻力、总机械通气时间、脱机时间、结果治疗组患者气道阻力降低、机械通气时间均优于对照组。治疗组从分组到通过SBT的机械通气时间和总机械通气时间均短于对照组(P=0.001),气道阻力降低优于对照组(P=0.01);Pa O_2及Pa CO_2组间比较无统计学差异(P=0.134、P=0.073),脱机成功率、脱机48 h后接受无创通气比率及再插管率组间无统计学差异(P=0.317、P=0.717、P=0.687),住院病死率组间比较无统计学差异(P=0.640)。结论机械辅助排痰结合体位引流有助于AECOPD患者机械通气的脱机。
[Abstract]:Objective to investigate the effect of mechanical assisted sputum drainage combined with conventional sputum tapping on mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 60 AECOPD patients who needed mechanical ventilation were randomly divided into two groups: mechanical assisted sputum drainage group (30 cases) and routine percussive sputum aspiration group (control group, 30 cases). The treatment group was treated by mechanical sputum drainage combined with body position, while the control group was treated by artificial percussive body drainage. Age, sex, previous underlying diseases, acute physiological and chronic health status score (APACHE) 鈪，

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