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目的探讨坐位有创机械通气,能否改善慢性阻塞性肺疾病(慢阻肺)患者的预后。方法将102例需有创机械通气的慢阻肺患者分为两组,采用不同体位,观察不同体位机械通气对患者脱机时间、呼吸机相关肺炎(VAP)的发生率、早发型VAP的发生率的影像。结果床边坐位组撤机平均时间为(6.76±1.89)d,传统组为(7.88±2.15)d,床边坐位组撤机时间明显优于传统组(P<0.01)。另通过分析发现坐位组VAP共有8例(16.0%),传统组的VAP共发生18例(34.6%),坐位组VAP发生率明显减少(P<0.05)。床边坐位组早发型VAP发生率为12.5%,传统组为66.7%,坐位组早发型VAP明显减少。结论坐位有创机械通气,能改善慢阻肺患者脱机时间,减少VAP的发生率,减少早发型VAP的发生率。
Objective To investigate whether the invasive mechanical ventilation can improve the prognosis of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 102 patients with COPD undergoing mechanical ventilation were divided into two groups. The different positions were used to observe the effects of mechanical ventilation on the off-line time, the incidence of ventilator-associated pneumonia (VAP), the occurrence of early-onset VAP Rate of the image. Results The average time of weaning in bedside sitting group was 6.76 ± 1.89 days, compared with 7.88 ± 2.15 days in traditional group. The weaning time in bedside sitting group was significantly higher than that in traditional group (P <0.01). In addition, we found that there were 8 cases (16.0%) in VAP sitting group and 18 cases (34.6%) in VAP sitting group. The incidence of VAP in sitting group was significantly decreased (P <0.05). The incidence of early onset VAP was 12.5% in bedside sitting group compared with 66.7% in conventional group, and the VAP in sitting group was significantly decreased. Conclusions Sit-invasive mechanical ventilation can improve offline COPD patients, reduce the incidence of VAP and reduce the incidence of early-onset VAP.