序贯机械通气治疗老年重症肺炎的临床疗效观察(1)
摘 要：目的 探讨序贯机械通气治疗老年重症肺炎患者疗效及对肺泡氧合功能的影响。方法 选取2015年6月～2017年6月在北大医疗鲁中医院住院治疗需行机械通气治疗的老年SCAP患者102例，随机分为两组，各51例，行有创机械通气治疗为常规组，有创机械通气序贯无创机械通气治疗为序贯组，观察两组疗效及肺泡氧合功能。结果 序贯组的总机械通气时间及住院时间均显著少于常规组(P<0.05)，其呼吸机相关性肺炎发生率(VAP)显著低于常规组(P<0.05)，而两组的再次插管率及院内死亡率差异不显著(P>0.05)；序贯组的PaO2及HCO3-浓度显著高于常规组(P<0.05)。结论 序贯机械通气治疗用于老年重症肺炎患者，可有效缩减患者机械通气时间，降低其VAP发生情况，提高患者肺泡氧合功能，临床疗效显著。
关键词：序贯机械通气；老年重症肺炎；肺泡氧合功能
中图分类号：R563.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.031
, 百拇医药
文章编号：1006-1959(2018)06-0099-03
Clinical Effect of Sequential Mechanical Ventilation on Elderly Patients with Severe Pneumonia
CHEN Li
(Department of Intensive Medicine，Luzhong Hospital，Peking University Medical Center，Zibo 255400，Shandong，China)
Abstract：Objective To investigate the effect of sequential mechanical ventilation on elderly patients with severe pneumonia and its effect on alveolar oxygenation function.Methods The patients who were hospitalized in Luzhong Hospital of Peking University from June 2015 to June 2017 were treated with mechanical ventilation.102 elderly patients with SCAP，the patients were randomly divided into two groups，51 cases in each group， treated with invasive mechanical ventilation as routine group and sequential non-invasive mechanical ventilation as sequential group.To observe the curative effect of the two groups and alveolar oxygenation.Results The total mechanical ventilation time of sequential group and hospitalization time were significantly less than the normal group(P<0.05)，the incidence of ventilator-associated pneumonia(VAP)was significantly lower than normal group(P<0.05)，while the reintubation rate and hospital mortality in the two groups no difference significant(P>0.05)；PaO2 and HCO3-concentration in sequential group was significantly higher than that of the conventional group(P<0.05).Conclusion The sequential mechanical ventilation in elderly patients with severe pneumonia，which can effectively reduce the time of mechanical ventilation of patients，reduce the incidence of VAP， improve lung oxygenation function of patients with global，clinical curative effect is remarkable.
, 百拇医药
Key words：Sequential mechanical ventilation；Severe pneumonia in the elderly；Alveolar oxygenation function
重癥肺炎全称为重症社区获得性肺炎(serious community acquired pneumonia，SCAP)，临床多采用有创机械通气治疗，虽可有助于稳定患者病情，改善其呼吸困难等症状，但长时间治疗极易诱发并发症，并且致使患者产生呼吸机依赖性，将增加患者脱机难度，不利于其病情控制[1，2]。本文现将序贯机械通气用于老年重症肺炎患者治疗中，探讨其疗效及对患者肺泡氧合功能的作用，现将结果报道如下。
1资料与方法
1.1 一般资料 选取2015年6月～2017年6月在北大医疗鲁中医院住院治疗需行机械通气治疗的老年SCAP患者102例。本次研究经医院伦理委员会批准。纳入标准：①均符合SCAP诊断标准者[3]；②PaO2/FiO2<150者；③无合并心肌梗死者；④无合并应激性溃疡者；⑤患者或家属均签署知情同意书。排除标准：①气管切开史者；②合并上消化道大出血者；③合并心源性休克者；④合并左心室心力衰竭者；⑤急性心肌梗死者；⑥癌症患者；⑦精神疾患或认知功能障碍者；⑧重要器脏严重病变者。按随机抽签法分为序贯组和常规组各51例，序贯组男28例，女23例，年龄60～81岁，平均年龄(63.64±12.64)岁，常规组男30例，女21例，年龄62～84岁，平均年龄 (64.11±12.39)岁。两组患者基线资料对比，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(陈丽)
关键词：序贯机械通气；老年重症肺炎；肺泡氧合功能
中图分类号：R563.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.031
, 百拇医药
文章编号：1006-1959(2018)06-0099-03
Clinical Effect of Sequential Mechanical Ventilation on Elderly Patients with Severe Pneumonia
CHEN Li
(Department of Intensive Medicine，Luzhong Hospital，Peking University Medical Center，Zibo 255400，Shandong，China)
Abstract：Objective To investigate the effect of sequential mechanical ventilation on elderly patients with severe pneumonia and its effect on alveolar oxygenation function.Methods The patients who were hospitalized in Luzhong Hospital of Peking University from June 2015 to June 2017 were treated with mechanical ventilation.102 elderly patients with SCAP，the patients were randomly divided into two groups，51 cases in each group， treated with invasive mechanical ventilation as routine group and sequential non-invasive mechanical ventilation as sequential group.To observe the curative effect of the two groups and alveolar oxygenation.Results The total mechanical ventilation time of sequential group and hospitalization time were significantly less than the normal group(P<0.05)，the incidence of ventilator-associated pneumonia(VAP)was significantly lower than normal group(P<0.05)，while the reintubation rate and hospital mortality in the two groups no difference significant(P>0.05)；PaO2 and HCO3-concentration in sequential group was significantly higher than that of the conventional group(P<0.05).Conclusion The sequential mechanical ventilation in elderly patients with severe pneumonia，which can effectively reduce the time of mechanical ventilation of patients，reduce the incidence of VAP， improve lung oxygenation function of patients with global，clinical curative effect is remarkable.
, 百拇医药
Key words：Sequential mechanical ventilation；Severe pneumonia in the elderly；Alveolar oxygenation function
重癥肺炎全称为重症社区获得性肺炎(serious community acquired pneumonia，SCAP)，临床多采用有创机械通气治疗，虽可有助于稳定患者病情，改善其呼吸困难等症状，但长时间治疗极易诱发并发症，并且致使患者产生呼吸机依赖性，将增加患者脱机难度，不利于其病情控制[1，2]。本文现将序贯机械通气用于老年重症肺炎患者治疗中，探讨其疗效及对患者肺泡氧合功能的作用，现将结果报道如下。
1资料与方法
1.1 一般资料 选取2015年6月～2017年6月在北大医疗鲁中医院住院治疗需行机械通气治疗的老年SCAP患者102例。本次研究经医院伦理委员会批准。纳入标准：①均符合SCAP诊断标准者[3]；②PaO2/FiO2<150者；③无合并心肌梗死者；④无合并应激性溃疡者；⑤患者或家属均签署知情同意书。排除标准：①气管切开史者；②合并上消化道大出血者；③合并心源性休克者；④合并左心室心力衰竭者；⑤急性心肌梗死者；⑥癌症患者；⑦精神疾患或认知功能障碍者；⑧重要器脏严重病变者。按随机抽签法分为序贯组和常规组各51例，序贯组男28例，女23例，年龄60～81岁，平均年龄(63.64±12.64)岁，常规组男30例，女21例，年龄62～84岁，平均年龄 (64.11±12.39)岁。两组患者基线资料对比，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(陈丽)