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目的探讨有创-无创序贯通气在慢性阻塞性肺部疾病急性加重(AECOPD)合并II型呼吸衰竭的临床疗效。方法 48例AECOPD合并II型呼吸衰竭的患者,以肺部感染控制窗为标准序贯无创机械通气的23例作为观察组,以同期常规自主呼吸试验(SBTs)逐渐脱机的25例作为对照组,比较两组的呼吸机相关性肺炎(VAP)发生率、机械通气时间、住ICU时间、病死率和再插管情况。结果比较两组患者VAP发生率、再插管率、拔管成功率、病死率,差异有统计学意义(P<0.05)。结论对于AECOPD合并II型呼吸衰竭的患者当出现感染控制窗后早期拔管序贯无创呼吸机辅助通气可以降低VAP的发生率、再插管率、拔管成功率及病死率。
Objective To investigate the clinical efficacy of invasive and noninvasive sequential ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type II respiratory failure. Methods Twenty-eight patients with AECOPD complicated with respiratory failure of Type II were randomly divided into control group (n = 23) and non-invasive mechanical ventilation (n = 23). The control group The incidences of ventilator-associated pneumonia (VAP), mechanical ventilation, ICU stay, mortality and re-intubation were compared between the two groups. Results The VAP incidence, reintubation rate, extubation success rate and mortality were compared between the two groups (P <0.05). CONCLUSIONS: In patients with AECOPD complicated with type II respiratory failure, early extubation of non-invasive ventilator-assisted ventilation after infection control window may reduce the incidence of VAP, reintubation, extubation success and mortality.