Clinical Analysis on Invasive-noninvasive Sequential Mechanical Ventilation in the Treatment of Chronic Obstructive Pulmonary Disease Complicated by Type Ⅱ Respiratory Failure_West China Medical Journal

Authors：

 FuBin , PanHongqiang , TangGuowen

Department of Internal Medicine, People's Hospital of Xuwen County, Xuwen, Guangdong 524100, P. R. China;

Corresponding?author：

Keywords：

Chronic obstructive pulmonary disease; Type Ⅱ respiratory failure; Mechanical ventilation treatment; Effect

DOI：

10.7507/1002-0179.201600331

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Objective To observe the clinical efficacy of invasive-noninvasive sequential mechanical ventilation in the treatment of chronic obstructive pulmonary disease (COPD) complicated by type Ⅱ respiratory failure. Methods A total of 100 patients with COPD complicated with type Ⅱ respiratory failure from March 2013 to April 2014 were randomly divided into control group and study group (with 50 patients in each). While the control group was given continuous invasive ventilation treatment, the study group was treated with invasive-noninvasive sequential ventilation. The ventilation time, Intensive Care Unit (ICU) monitoring and hospitalization time, the serum concentrations of C-reactioin protein (CRP) before and after treatment and the ventilator associated pneumonia (VAP) and hospital mortality rate were observed and compared between the two groups. Results For patients in the study group, ICU monitoring time, ventilation time and hospitalization time were (9.4±8.1), (10.3±5.8), and (14.7±8.2) days, respectively, significantly shorter than those in the control group[(17.5±10.8), (15.2±7.7), and (22.8±7.4) days] (P<0.05). The incidence of VAP and nosocomial VAP mortality in the study group were 4.0% and 2.0% respectively, which were significantly lower than those in the control group (22.0% and 20.0%), and the differences were statistically significant (P<0.05). Conclusion In the clinical treatment of COPD patients with type Ⅱ respiratory failure, invasive-noninvasive sequential ventilation treatment is effective in shortening the duration of ventilation and hospitalization time, controlling the incidence of VAP, and reducing the mortality rate, which is worthy of clinical popularization.

Citation： FuBin, PanHongqiang, TangGuowen. Clinical Analysis on Invasive-noninvasive Sequential Mechanical Ventilation in the Treatment of Chronic Obstructive Pulmonary Disease Complicated by Type Ⅱ Respiratory Failure. West China Medical Journal, 2016, 31(7): 1213-1215. doi: 10.7507/1002-0179.201600331 Copy

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9.	黃少祥. 慢性阻塞性肺疾病患者的營養支持治療[J]. 中國慢性病預防與控制, 2013, 21(4):494-497.
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11.	李為春. 無創機械通氣治療COPD合并Ⅰ 型呼吸衰竭療效觀察[J]. 臨床肺科雜志, 2011, 16(2):175-176.
12.	佘小銀, 穆菊香. 序貫通氣在慢性阻塞性肺疾病合并呼吸衰竭患者撤機中的應用[J]. 內科急危重癥雜志, 2014, 20(6):401-402.
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14.	王海清, 賈曉民, 趙杰, 等. COPD合并 Ⅱ型呼吸衰竭患者機械通氣應用不同方法的療效比較[J]. 中國現代醫生, 2012, 50(27):20-21.
15.	朱桂保. 早期序貫無創減少慢性阻塞性肺疾病急性發作患者機械通氣時間的效果[J]. 吉林醫學, 2015, 36(14):2993-2995.
16.	陳泳祥. 無創機械通氣治療COPD合并 Ⅱ型呼吸衰竭療效觀察[J]. 泰山醫學院學報, 2013, 34(11):860-861.
17.	李航, 王臣玉, 初美華, 等. 家庭無創正壓機械通氣治療穩定期重度慢性阻塞性肺疾病患者的臨床研究[J]. 中華結核和呼吸雜志, 2011, 34(7):540-542.
18.	陳衛民, 黎銀煥, 鐘映笑. 有創無創序貫性機械通氣治療慢性阻塞性肺疾病致嚴重呼吸衰竭的臨床分析[J]. 臨床醫學工程, 2016, 23(4):461-462.

1. 華瓊, 江蓮. 不同方法治療COPD合并 Ⅱ型呼吸衰竭的療效觀察[J]. 臨床肺科雜志, 2011, 16(6):889-890.
2. 袁順蓉, 劉南伶, 楊三春, 等. 有創無創序貫機械通氣治療慢性阻塞性肺疾病合并 Ⅱ型呼吸衰竭的臨床研究[J]. 西部醫學, 2014, 26(9):1176-1178.
3. 史鵬, 安東善, 王樹岐. 無創正壓機械通氣聯合霧化吸入治療慢性阻塞性肺疾病合并 Ⅱ型呼吸衰竭患者的臨床效果[J]. 中國藥物經濟學, 2015, 25(4):87-89.
4. 黃柳秋, 李少軍. 無創呼吸機治療慢性阻塞性肺疾病急性加重期呼吸衰竭臨床分析[J]. 華西醫學, 2014, 29(10):1810-1813.
5. 楊麗霞, 董麗, 閆麗麗, 等. 序貫機械通氣在COPD合并 Ⅱ型呼吸衰竭中的應用研究[J]. 臨床肺科雜志, 2013, 18(5):929-930.
6. 黃華興, 陳飛鵬. 以肺部感染控制窗為切換點的序貫機械通氣治療慢性阻塞性肺疾病所致呼吸衰竭臨床研究的Meta分析[J]. 實用醫學雜志, 2013, 29(4):646-649.
7. 周柳如, 張平, 黃潘文, 等. 有創-無創序貫機械通氣治療慢性阻塞性肺疾病急性加重期合并 Ⅱ型呼吸衰竭的可行性分析[J]. 齊齊哈爾醫學院學報, 2015, 36(13):1946-1947.
8. 馬壯. 對呼吸機相關性肺炎診斷標準的商榷[J]. 中華內科雜志, 2014, 53(8):598.
9. 黃少祥. 慢性阻塞性肺疾病患者的營養支持治療[J]. 中國慢性病預防與控制, 2013, 21(4):494-497.
10. García Vicente E, Sandoval Almengor JC, Díaz Caballero LA, et al. Invasive mechanical ventilation in COPD and asthma[J]. Med Intensiva, 2011, 35(5):288-298.
11. 李為春. 無創機械通氣治療COPD合并Ⅰ 型呼吸衰竭療效觀察[J]. 臨床肺科雜志, 2011, 16(2):175-176.
12. 佘小銀, 穆菊香. 序貫通氣在慢性阻塞性肺疾病合并呼吸衰竭患者撤機中的應用[J]. 內科急危重癥雜志, 2014, 20(6):401-402.
13. Farah R, Makhoul N. Optimal time needed for withdrawal of mechanical ventilation in patients with chronic obstructive pulmonary disease[J]. Isr Med Assoc J, 2011, 13(10):609-612.
14. 王海清, 賈曉民, 趙杰, 等. COPD合并 Ⅱ型呼吸衰竭患者機械通氣應用不同方法的療效比較[J]. 中國現代醫生, 2012, 50(27):20-21.
15. 朱桂保. 早期序貫無創減少慢性阻塞性肺疾病急性發作患者機械通氣時間的效果[J]. 吉林醫學, 2015, 36(14):2993-2995.
16. 陳泳祥. 無創機械通氣治療COPD合并 Ⅱ型呼吸衰竭療效觀察[J]. 泰山醫學院學報, 2013, 34(11):860-861.
17. 李航, 王臣玉, 初美華, 等. 家庭無創正壓機械通氣治療穩定期重度慢性阻塞性肺疾病患者的臨床研究[J]. 中華結核和呼吸雜志, 2011, 34(7):540-542.
18. 陳衛民, 黎銀煥, 鐘映笑. 有創無創序貫性機械通氣治療慢性阻塞性肺疾病致嚴重呼吸衰竭的臨床分析[J]. 臨床醫學工程, 2016, 23(4):461-462.

West China Medical Journal

Clinical Analysis on Invasive-noninvasive Sequential Mechanical Ventilation in the Treatment of Chronic Obstructive Pulmonary Disease Complicated by Type Ⅱ Respiratory Failure

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