Clinical effect of invasive-noninvasive mechanical ventilation step-down therapy on patients with dysfunctional ventilatory weaning response
Objective To study the clinical value of invasive-noninvasive mechanical ventilation step-down therapy on patients with dysfunctional ventilatory weaning response (DVWR). Methods 95 patients with DVWR were divided into an observation group (47 cases) and a control group (48 cases) according to computer random number table method. The control group was treated with continuous mechanical ventilation,and the observation group was treated with invasive and non-invasive mechanical ventilation step-down therapy. Patients in both groups were compared in terms of vital signs (systolic blood pressure,diastolic blood pressure,heart rate,respiratory rate),blood gas indicators[arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2),pH,base excess (BE)]and quality of life before and after treatment,success rate of ventilator weaning,length of intensive care unit (ICU) stay,and in-hospital mortality. Results Before treatment,the systolic blood pressure,diastolic blood pressure,heart rate and respiratory rate of the observation group were (122.42±7.94) mm Hg,(70.42±3.45) mm Hg (1 mm Hg=0.133 kPa),(87.11±4.21) beats/min and (20.17±3.02) times/min,the control group were (122.37±7.82) mm Hg,(70.37±3.51) mm Hg,(87.20±4.18) beats/min and (20.20±3.04) times/min. After 24 h of treatment,the systolic blood pressure,diastolic blood pressure,heart rate and respiratory rate of the observation group were (121.76±8.01) mm Hg,(70.48±3.26) mm Hg,(88.60±4.55) beats/min and (21.33±3.16) times/min,while those of the control group were (122.05±7.96) mm Hg,(70.50±3.31) mm Hg,(88.59±4.79) beats/min and (20.78±3.12) times/min. There were no significant differences in systolic blood pressure,diastolic blood pressure,heart rate and respiratory rate between two groups before and after treatment (P>0.05). Before treatment,PaO2,PaCO2,pH and BE of the observation group were (95.22±10.30) mm Hg,(40.38±3.19) mm Hg,(7.51±0.12) and (5.10±0.14) mmol/L,while those of the control group were (95.05±10.27) mm Hg,(40.45±3.21) mm Hg,(7.51±0.13) and (5.12±0.13) mmol/L. After 24 h of treatment,PaO2,PaCO2,pH and BE of the observation group were (92.48±8.37) mm Hg,(40.19±3.21) mm Hg,(7.53±0.13) and (5.20±0.12) mmol/L,while those of the control group were (93.11±8.42) mm Hg,(40.34±3.20) mm Hg,(7.52±0.14) and (5.17±0.13) mmol/L. There were no significant differences in PaO2,PaCO2,pH and BE between the two groups before and after treatment (P>0.05). The success rate of ventilation weaning of 48.94％ in the observation group was higher than 29.17％ in the control group,and the length of ICU stay of (15.23±3.84) d was shorter than (20.51±4.91) d in the control group. The difference was significant (P<0.05). The quality of life scores of the observation group and the control group were (35.12±3.48) and (34.78±3.50) points before treatment,and (76.10±6.23) and (69.38±4.17) points after 24 weeks of treatment. After 24 weeks of treatment,the quality of life score in both group were higher than that before treatment,and the observation group was higher than the control group. The difference was significant (P<0.05). Conclusion The application of invasive-noninvasive mechanical ventilation step-down therapy in patients with DVWR is more effective,which can improve the success rate of ventilatory weaning,shorten the length of ICU stay of patients,and is conducive to the improvement of patients' quality of life.
TracheotomyDysfunctional ventilatory weaning responseInvasive-noninvasive mechanical ventilation step-down therapyFunctional value
万方数据
维普
