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目的探讨呼吸系统功能评分在慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者撤离呼吸机中的评估价值。方法随机选取火炬开发区医院2011年1月至2013年2月诊治的需行气管插管机械通气治疗的COPD急性发作并发呼吸衰竭患者72例,随机分为观察组38例和对照组34例,观察组患者根据呼吸功能评分结果选择撤机时机,对照组依据传统撤机方法撤机,比较两组撤机成功率和并发症发生率情况。结果观察组直接撤机成功率和再插管率分别为94.74%和0,与对照组比较差异无统计学意义(P>0.05);但观察组患者机械通气时间为(5.97±0.54)h,明显短于对照组(P<0.05);且观察组呼吸机相关性肺炎和肺部气压伤的发生率均明显低于对照组,差异有统计学意义(P<0.05)。结论以呼吸功能评分结果作为撤机依据,在不影响直接撤机成功率的条件下可明显缩短通气时间,具有较高的安全可行性,适用于临床推广使用。
Objective To investigate the assessment of respiratory system function score in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. Methods 72 cases of acute exacerbation of COPD complicated by respiratory failure who underwent endotracheal intubation mechanical ventilation for treatment from January 2011 to February 2013 in the hospital of Torch Development Hospital were randomly divided into observation group (38 cases) and control group (34 cases) Patients in the observation group were given the opportunity of weaning according to the score of respiratory function. The control group was weaned according to the traditional weaning method. The success rate of the weaning and the complication rate of the two groups were compared. Results The success rate of direct weaning and reintubation in the observation group were 94.74% and 0, respectively, with no significant difference from the control group (P> 0.05). However, the duration of mechanical ventilation in the observation group was (5.97 ± 0.54) h, (P <0.05). The incidence of ventilator-associated pneumonia and pneumoconiosis in the observation group was significantly lower than that in the control group (P <0.05). Conclusion The results of respiratory function as a basis for weaning, without affecting the success rate of direct weaning can significantly shorten the ventilation time, with high safety and feasibility for clinical use.