摘要
目的探讨NAVA与PSV两种机械通气方法在COPD患者撤机中的应用及效果比较。方法选择2011年12月至2012年12月我院综合重症监护病房（ICU）收治的48例机械通气的慢性阻塞性肺疾病（COPD）患者。满足撤机条件后，分别采用NAVA方法与PSV方法撤机治疗，对比两种撤机方式在COPD患者撤机中的差异。结果24例应用NAVA撤机的患者中23例（96.8%）撤机后未再行呼吸机辅助通气，患者无撤机后行无创呼吸机序贯辅助通气，1例（3.2%）患者撤机失败。24例应用PSV撤机的患者20例（83.3%）撤机成功，4例（16.7%）患者撤机失败，继续呼吸机辅助通气治疗。与PSV组比较，NAVA组有创通气时间缩短[（4.29±1.46）d比（5.25±1.03） d，P＜0.01]，ICU住院天数显著缩短[（4.67±1.57）d比（6.17±1.88）d，P＜0.01]。总住院时间、呼吸机相关肺炎发生率和病死率均无差异（P＞0.05）。结论 NAVA是近年应用于临床的新的机械通气模式。根据膈肌电位触发呼吸机辅助通气，在COPD患者撤机方面较传统的PSV撤机方式具有更接近生理、撤机成功率高的优点，可以缩短机械通气时间和ICU住院时间。
Abstract
Objective To investigate the NAVA and PSV two kinds of mechanical ventilation weaning patients with COPD methods of application and effect of comparison. Methods from December 2011 to December 2012 a comprehensive hospital intensive care unit (ICU) were treated 48 cases of mechanical ventilation in chronic obstructive pulmonary disease (COPD) patients. To meet the weaning conditions, respectively NAVA method and PSV weaning method of treatment, compared to two kinds of way in weaning patients with COPD in the differences in weaning. Results of 24 cases application of NAVA weaning patients, 23 cases (96.8%), after weaning from mechanical ventilation did not re-ventilation, patients without weaning Across sequential non-invasive ventilator-assisted ventilation, 1 patient (3.2%) patients weaning failure. 24 cases of application of PSV weaning patients 18 cases (83.3%), weaning Across Sequential non-invasive ventilation after ventilator weaning success in 4 cases (16.7%) patients weaning Failure to continue treatment of ventilator-assisted ventilation. With the PSV group, NAVA group [invasive ventilation time (4.29 ± 1.46) d ratio (5.25 ± 1.03) d, P<0.01], ICU length of stay significantly shorter [(4.67 ± 1.57) d ratio (6.17 ± 1.88) d, P<0.01]. The total length of stay, ventilator-associated pneumonia incidence and mortality did not differ significantly (P>0.05). Conclusions NAVA is a recent clinical application of new mechanical ventilation. According to potential triggers diaphragmatic breathing machine assisted ventilation in weaning patients with COPD in a more traditional way with PSV weaning is closer to the physical, weaning the advantages of high success rate can be reduced by mechanical ventilation time and ICU length of stay.
NETL
NSTL
维普
万方数据