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目的观察序贯性机械通气在危重支气管哮喘患者的应用价值。方法选择危重支气管哮喘患者72例,随机分为序贯治疗组和对照组,每组36例,在内科综合治疗基础上,序贯治疗组依次选择BiPAP→A/C→SIMV或SIMV+PSV→BiPAP或PSV+PEEP通气模式,而对照组选择A/C→SIMV通气模式。结果序贯治疗组有创通气时间、总机械通气时间、发生呼吸机相关性肺炎(VAP)、撤机失败、住院时间与对照组比较差异均有统计学意义(P<0.05)。结论危重支气管哮喘患者采用无创-有创-无创性序贯通气是治疗危重支气管哮喘行之有效的手段,能明显缩短有创通气时间,降低VAP发生率,减少撤机失败,缩短住院时间,降低病死率。
Objective To observe the value of sequential mechanical ventilation in critically ill patients with bronchial asthma. Methods Seventy - two patients with severe bronchial asthma were randomly divided into sequential treatment group and control group, with 36 cases in each group. On the basis of comprehensive medical treatment, sequential treatment group followed by BiPAP → A / C → SIMV or SIMV + PSV → BiPAP or PSV + PEEP ventilation mode, while the control group selected A / C → SIMV ventilation mode. Results In sequential therapy group, there were significant differences in invasive ventilation time, total mechanical ventilation time, occurrence of ventilator associated pneumonia (VAP), weaning failure, hospitalization time and control group (P <0.05). Conclusions Noninvasive-invasive and noninvasive sequential ventilation in critically ill patients with bronchial asthma is an effective treatment for critically ill patients with bronchial asthma. It can shorten the duration of invasive ventilation, reduce the incidence of VAP, reduce the failure of weaning, shorten the length of hospital stay and decrease Case fatality rate.