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目的:了解小潮气量联合低水平PEEP机械通气治疗慢性阻塞性肺疾病(COPD)伴呼衰并肺大泡的疗效及安全性。方法:49例COPD伴呼衰并肺大泡的患者随机分为常规通气组(Ⅰ)24例和小潮气量联合低水平PEEP组(Ⅱ)25例,比较两组通气时间、气压伤发生率及病死率。结果:Ⅱ组气压伤发生率、通气时间显著低于Ⅰ组,两组病死率差异无统计学意义。结论:小潮气量联合低水平PEEP机械通气治疗COPD伴呼衰并肺大泡疗效较好,值得临床推广应用。
Objective: To investigate the efficacy and safety of low tidal volume combined with low-level PEEP mechanical ventilation in the treatment of chronic obstructive pulmonary disease (COPD) with respiratory failure and pulmonary bullae. Methods: Forty-nine COPD patients with respiratory failure and pulmonary bullae were randomly divided into routine ventilation group (Ⅰ) 24 cases and low tidal volume combined with low PEEP group (Ⅱ) 25 cases. The incidence of airway pressure, Case fatality rate. Results: The incidence of barotrauma and ventilation in group Ⅱ were significantly lower than those in group Ⅰ, and there was no significant difference in mortality between two groups. Conclusion: Low tidal volume combined with low level of PEEP mechanical ventilation for COPD with respiratory failure and pulmonary bullae better curative effect, worthy of clinical application.