摘要
目的评价机械通气（ＭＶ）治疗老年Ⅱ型呼吸衰竭的临床意义，提出治疗的适应证，讨论并发症的种类和发生率，及其防治方法。方法回顾分析１９７７年１月～１９９４年４月１８年间我科收治的３２例老年Ⅱ型呼吸衰竭患者，根据不同人工气道和呼吸机类型，评价各自的优缺点，并强调同步间歇指令呼吸（ＳＩＭＶ）和压力支持通气（ＰＳＶ）呼吸模式的应用价值。结果ＭＶ治疗老年Ⅱ型呼吸衰竭的成功率为７５％。２例存活５年以上。本组１３例采用延长的气管插管（７ｄ～２１ｄ，平均１６±２．１３ｄ）。８例长期保留气管切开套管。讨论ＭＶ救治老年Ⅱ型呼吸衰竭疗效肯定，采用ＳＩＭＶ和ＰＳＶ呼吸模式有利于撤机，延长气管插管当因人而异，对高龄及第２次切开应考虑长期带管。
Objective The indication, complications and clinical value of mechanical ventilation (MV) in the treatment of elderly patients with type Ⅱ respiratory failure were evaluated.The methods to prevent and treat the complications of MV were also discussed.Methods 32 elderly patients with type Ⅱ respiratory failure were analyzed retrospectively (hospitalized in our Department from January 1977 to April 1996). We have evaluated the advantages and defects of different kinds of artificial airways and respirators and emphasized the clinical value of ventilation models of SIMV and PSV.Results The success rate of MV therapy was 75% and 2 cases had survived for more than 5 years. In this group, the intratracheal intubation of 13 patients were prolonged (7～21 days, average 16±2 13 days). The tracheotomy cannula of 8 patients was kept for a long time. Conclusions MV is an effective treatment for elderly patients with type Ⅱ respiratory failure. The ventilation models of SIMV and PSV were useful for weaning from respirator. Prolongation of intratracheal intubation should be individualized. The tube could be kept for a long time for the elderly patients and second time tracheotomy patients.
出处
《实用老年医学》
CAS
1997年第2期68-69,共2页
Practical Geriatrics
