慢性阻塞性肺病并呼吸衰竭患者机械通气撤机指标的临床探讨
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[摘要] 目的 探究慢性阻塞性肺病并呼吸衰竭患者机械通气的撤机指标。 方法 选取本院2012年3月～2014年3月重症监护病房80例慢性阻塞性肺病并呼吸衰竭患者作为研究对象，检测通气时间>72 h的患者达到临床脱机标准后血气分析、呼吸力学以及肺功能的改变情况。 结果 成功撤机47例（成功组），失败33例（失败组）。两组pH、PaCO2、PaO2、动态顺应性、平均气道阻力、氧合指数比较，差异均无统计学意义（P>0.05）。两组肺活量/潮气量、最大吸气负压及浅快呼吸指数比较，差异均有统计学意义（P
[关键词] 慢性阻塞性肺病；呼吸衰竭；机械通气；撤机指标
[中图分类号] R563.8 [文献标识码] A [文章编号] 1674-4721（2015）01（b）-0025-03
Clinical exploration of weaning indexes of mechanical ventilation in patients with chronic obstructive pulmonary disease combined with respiratory failure
HUANG Xiang-ling ZHONG Xiang-zhu TAO Fei WU Xiao-di
Department of Internal Medicine，Foshan Chancheng Hospital Affiliated to Guangdong Medical College，Foshan 528031，China
[Abstract] Objective To explore the weaning indexes of mechanical ventilation in patients with chronic obstructive pulmonary disease（COPD）combined with respiratory failure. Methods 80 patients with COPD and respiratory failure in our hospital from March 2012 to March 2014 were selected as research objects.Blood gas analysis，breathing mechanics and pulmonary function were tested in patients whose ventilation period was over 72 hours and who met the criteria of clinical weaning. Results Successful weaning was in 47 cases（successful group）and failure in 33 cases（failure group）.pH，PaCO2，PaO2，dynamic adaptation，airway resistance and oxygenation index in two groups was compared respectively，with no statistical difference（P>0.05）.Indexes of vital capacity per tidal volume，peak inspiratory negative pressure and rapid shallow respiration in two groups was compared respectively，with statistical difference（P
[Key words] Chronic obstructive pulmonary disease；Respiratory failure；Mechanical ventilation；Weaning index
慢性阻塞性肺病是一种具有气流受限特征的疾病[1]，其主要特点为气流受限不完全可逆，肺功能呈现进行性减退，严重影响患者的身体健康和生活质量，甚至导致患者死亡，是居世界第四位的死亡疾病[2]。呼吸衰竭是由于患者肺通气与换气功能发生障碍，肺不能完成正常的气体交换，致患者动脉血氧分压降低或二氧化碳潴留，由此产生一系列的生理功能紊乱以及代谢障碍的临床综合征。据有关文献报道，机械通气的慢性阻塞性肺病患者不能撤机占25.0%～60.0%[3]。近年来，有学者认为，浅快呼吸指数是最佳的撤机指标之一[4]。本文主要研究本院慢性阻塞性肺病并呼吸衰竭患者进行机械通气的撤机指标。
1 资料与方法
1.1 一般资料