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对16例慢性阻塞性肺疾病所致严重呼吸衰竭患者采用插管机械通气治疗,待肺部感染明显控制、出现“肺部感染控制窗”时拔除气管插管,代之以无创正压通气治疗。选择同样病情的慢性阻塞性肺疾病的呼吸衰竭患者15例作为对照,按常规行有创机械通气治疗,同步间歇强制通气+压力支持通气方式辅助撤机。结果两组患者出现感染控制窗的时间及当时病情相近(P>0.05)。有创机械通气时间、总机械通气时间、总住院时间和呼吸机相关性肺炎发生率差异均有统计学意义(均P<0.05)。
Sixteen patients with severe respiratory failure caused by chronic obstructive pulmonary disease were treated with intubation mechanical ventilation until the pulmonary infection was obviously controlled. When the “pulmonary infection control window” appeared, the endotracheal intubation was removed and replaced by noninvasive positive pressure ventilation . Fifteen patients with respiratory failure who had the same condition of chronic obstructive pulmonary disease (CKD) were selected as control. The patients underwent routine mechanical ventilation, and intermittent forced ventilation and pressure-supported ventilation assisted the weaning. Results The time of infection control window and the condition at that time in both groups were similar (P> 0.05). The differences of invasive mechanical ventilation time, total mechanical ventilation time, total length of hospital stay and ventilator-associated pneumonia were statistically significant (all P <0.05).