浙江医学2018，Vol.40Issue(16)：1823-1826,4.DOI:10.12056/j.issn.1006-2785.2018.40.16.2017-1107
治疗COPD所致呼吸衰竭以改良GCS评分≥13分作为有创-无创序贯通气切换点的效果观察
Using improved Glasgow coma scale score 13 as switching point for invasive to noninvasive ventilation in chronic obstructive pulmonary disease(COPD) patients with respiratory failure
摘要
Abstract
Objective To analyze the effectiveness and feasibility of using improved Glasgow coma scale (GCS) score 13 as the switching point for invasive to noninvasive ventilation in chronic obstructive pulmonary disease (COPD) patients with respiratory failure. Methods Eighty COPD patients with respiratory failure in ICU were randomly divided into group A (n=40) and group B (n=40). In group A, the endotracheal tube was extubated and the noninvasive ventilation was used when the improved GCS score reached 13; in group B, the endotracheal tube was extubated and noninvasive ventilation was used when the GCS score of 10 was reached. The incidence rate of ventilator associated pneumonia (VAP), need of reintubation, time of invasive ventilation and time of hospitalization were compared between two groups. Results Compared to group B, the time of invasive ventilation in group A was significantly lower (P＜0.05). There were no significant differences between group A and group B in the incidence rates of VAP, rate of reintuhation, length of hospital stay (all P ＞0.05). There were no significant differences in oxygenation index, mean arterial pressure, oxygen partial pressure, carbon dioxide partial pressure before and 3h after extubation (all P ＞0.05). Conclusion The using of improved GCS score of 13 as the switching point for invasive to noninvasive ventilation can significantly improve the therapeutic effect in COPD patients with respiratory failure.关键词
呼吸衰竭/慢性阻塞性肺疾病/改良格拉斯哥昏迷评分/机械通气/撤机Key words
Respiratory failure/Chronic obstructive pulmonary disease (COPD)/Improved glasgow coma scale score/Mechanical ventilation/Ventilator weaning引用本文复制引用
林肖琴,吴仙丹,张近波,张丽红,朱金强,宋于康,金晓红,鄢来超,董美平,曹烈祥..治疗COPD所致呼吸衰竭以改良GCS评分≥13分作为有创-无创序贯通气切换点的效果观察[J].浙江医学,2018,40(16):1823-1826,4.基金项目
温岭市科技局课题(2014C31BA0032) （2014C31BA0032）
