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目的 了解有创 无创机械通气序贯治疗过程中慢性阻塞性肺疾病 (COPD)患者呼吸和循环功能的变化 ,以评价该方法实施中的生理学效应。方法 选择接受气管插管机械通气的COPD患者 12例 ,待“肺部感染控制窗”出现后 ,拔除气管插管 ,改用经鼻面罩压力支持通气 +呼气末正压(PSV +PEEP)。分别于“肺部感染控制窗”出现后有创机械通气条件下 ,拔管后无创机械通气 3h及鼻导管吸氧 1h的条件下测定患者的呼吸和循环功能的变化。结果 有创机械通气改为无创机械通气后 ,呼吸、循环各项指标变化均无统计学意义 (P均 >0 0 5 )。结论 有创 无创机械通气序贯撤机过程中 ,患者的呼吸和循环功能稳定 ,能够平稳地接受由有创性机械通气向无创性机械通气治疗的转换。
Objective To investigate changes in respiratory and circulatory function in patients with chronic obstructive pulmonary disease (COPD) during sequential noninvasive mechanical ventilation to evaluate the physiological effects of this approach. Methods Twelve patients with COPD undergoing endotracheal intubation mechanical ventilation were selected. After pulmonary infection control window appeared, the endotracheal intubation was withdrawn and the nasal mask pressure support ventilation + positive end expiratory pressure (PSV + PEEP) was used instead. Respiratory and circulatory functions were measured in patients undergoing invasive mechanical ventilation following emergence of a pulmonary infection control window, 3 h after extubation, and 3 h of nasal catheter oxygenation respectively. Results After mechanical ventilation was changed to noninvasive mechanical ventilation, there were no significant differences in respiration and circulation (P> 0.05). Conclusions During invasive and noninvasive mechanical ventilation, the patient’s respiratory and circulatory function is stable during the sequential weaning, and the transition from invasive mechanical ventilation to non-invasive mechanical ventilation can be smoothly accepted.