论文部分内容阅读
目的探讨经鼻气管插管机械通气治疗慢性阻塞性肺疾病急性呼吸衰竭患者拔管的适宜时机。方法26例慢性阻塞性肺疾病急性呼吸衰竭患者经鼻气管插管机械通气治疗72h后,随机分成A、B两组,每组13例,A组拔管后改面罩吸氧机械通气。B组继续经鼻气管插管机械通气。观察两组呼吸机相关肺炎(VAP)例数腹泻例数、死亡例数、机械通气时间及住院时间。结果A、B两组发生VAP的例数分别为1、8例(P=0.0281),死亡例数为0、3例(P=0.0219),腹泻例数分别为2、8例(P=0.0292),经鼻插管通气72h后尚需机械通气时间为(7±6)d和(16±11)d(P<0.05),住院时间为(15±7)d和(26±13)d(P<0.05)。结论经鼻气管插管机械通气治疗慢性阻塞性肿疾病急性呼吸衰竭患者72h后拔管改面罩机械通气能降低VAP,及腹泻发生率、缩短机械通气时间和住院时间。
Objective To investigate the appropriate timing of intubation through nasotracheal intubation for acute exacerbation of chronic obstructive pulmonary disease. Methods Twenty-six patients with acute respiratory failure of chronic obstructive pulmonary disease were treated with mechanical ventilation of nasotracheal intubation for 72 hours. They were randomly divided into A group and B group, with 13 cases in each group. Group B continued nasotracheal intubation mechanical ventilation. The number of diarrhea cases, the number of deaths, the time of mechanical ventilation and the length of hospital stay were observed in two groups of patients with ventilator-associated pneumonia (VAP). Results The incidences of VAP in group A and group B were 1.8 (P = 0.0281), 0.3 (P = 0.0219) and 2 and 8 (P = 0.0292, ), The duration of mechanical ventilation was (7 ± 6) days and (16 ± 11) d (P <0.05) and the length of hospital stay was (15 ± 7) days and (26 ± 13) days (P <0.05). Conclusion Mechanical ventilation through nasotracheal intubation for 72 h after acute exacerbation of chronic obstructive disease can reduce VAP, reduce the incidence of diarrhea and shorten the duration of mechanical ventilation and hospital stay.