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目的探讨老年人慢性阻塞性肺疾病 (COPD)急性呼吸衰竭患者的临床特点及机械通气治疗策略。方法回顾分析 14例采用机械通气治疗的老年人COPD急性呼衰患者的临床资料。结果A组有创通气时间 3～ 6天 ,无与呼吸机相关性肺炎 (VAP)发生 ;B组有创通气时间 8～ 19天 ,发生VAP 4例 ;A组无死亡 ,B组死亡 4例 ;A组住ICU时间 (7.3± 1.7)天 ,B组 (15 .3± 6 .0 )天。结论老年人COPD急性呼吸衰竭机械通气治疗成功率高 ,有创通气时间短 ,无VAP发生 ,住ICU时间短。但因老年人对咳嗽反射弱、咳痰无力、一般情况差故不能过早拔管。
Objective To investigate the clinical characteristics of elderly patients with chronic obstructive pulmonary disease (COPD) with acute respiratory failure and the strategy of mechanical ventilation. Methods The clinical data of 14 elderly COPD patients with acute respiratory failure treated with mechanical ventilation were retrospectively analyzed. Results In group A, the duration of invasive ventilation was 3-6 days without ventilator-associated pneumonia (VAP). In group B, the duration of invasive ventilation was 8-19 days, with 4 cases of VAP. There was no death in group A and 4 deaths in group B ; ICU patients in group A (7.3 ± 1.7) days, group B (15.3 ± 6.0 days). Conclusion The success rate of mechanical ventilation in COPD patients with acute respiratory failure is high. The duration of invasive ventilation is short, no VAP occurs and the ICU residence time is short. However, due to the elderly to cough reflex weak, weakness, phlegm in general should not be excused.