有创无创序贯机械通气抢救重症老年呼吸衰竭患者的有效性与安全性

发布时间：2018-05-31 00:04

  本文选题：呼吸衰竭 + 有创机械通气　； 参考：《中国老年学杂志》2014年17期

【摘要】：目的研究有创无创序贯机械通气抢救重症呼吸衰竭老年患者的有效性与安全性。方法选择2011年1月至2014年1月在该院接受机械通气治疗的重症呼吸衰竭老年患者90例作为研究对象,根据机械通气的方法不同将纳入者分为接受有创无创序贯机械通气的观察组和持续有创机械通气的对照组,比较两组患者的治疗情况、呼吸及血气相关指标、应激反应程度。结果 (1)治疗情况:观察组撤管成功率明显高于对照组;呼吸机相关肺炎发生率、再插管率、死亡率、PaO2/FiO2恢复正常时间、胸片征象消失时间、机械通气时间、住院时间均明显低于对照组;(2)呼吸及血气相关指标:观察组患者的pH值、PaO2、SaO2明显高于对照组,PaCO2、RR、HR值明显低于对照组;(3)应激反应:观察组患者肾上腺素、去甲肾上腺素、肾素以及血管紧张素Ⅱ水平均低于对照组。结论有创无创序贯机械通气有助于临床症状和体征的恢复、缩短机械通气时间、减少并发症发生、改善肺泡氧合情况、缓解应激反应,是呼吸衰竭安全、有效的治疗措施。
[Abstract]:Objective to study the efficacy and safety of noninvasive sequential mechanical ventilation in the treatment of elderly patients with severe respiratory failure. Methods 90 elderly patients with severe respiratory failure who received mechanical ventilation from January 2011 to January 2014 were selected as the study subjects. According to the different methods of mechanical ventilation, the participants were divided into two groups: the observation group receiving invasive and non-invasive sequential mechanical ventilation and the control group with continuous invasive mechanical ventilation. The treatment, respiratory and blood gas related indexes and stress response were compared between the two groups. Results 1) treatment: the success rate of withdrawing tube in the observation group was significantly higher than that in the control group, the incidence of ventilator-associated pneumonia, the rate of re-intubation, the death rate and the time of Pao _ 2 / FiO _ 2 returning to normal, the time of disappearance of chest radiographs, the time of mechanical ventilation, The relative indexes of respiratory and blood gas: the pH value of the patients in the observation group was significantly higher than that in the control group (P < 0.05). The RRHR of the patients in the observation group was significantly lower than that in the control group (P < 0.05). The levels of renin and angiotensin 鈪，

本文编号：1957406