摘 要
慢性阻塞性肺疾病（COPD）是导致呼吸衰竭的主要原因之一，机械通气作为重要治疗手段，其策略选择对患者预后至关重要。本研究旨在探讨不同机械通气模式及参数设置对COPD合并呼吸衰竭患者的临床疗效与安全性。通过对某三甲医院2018 - 2023年收治的320例COPD伴急性加重期呼吸衰竭患者进行回顾性分析，根据所采用的机械通气方式分为无创正压通气组、有创正压通气组以及序贯机械通气组。结果表明，序贯机械通气在改善血气指标、缩短机械通气时间及ICU住院时长方面具有显著优势，且能降低气管插管率和相关并发症发生率。创新点在于首次系统比较了三种通气模式在COPD患者中的应用效果，并提出基于患者个体特征优化通气策略的新思路，为临床制定个性化机械通气方案提供了理论依据，有助于提高救治成功率并改善患者生活质量。
关键词：机械通气；序贯机械通气；呼吸衰竭施
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the main causes of respiratory failure, and mechanical ventilation, as an important treatment, is crucial to patient prognosis. This study aims to investigate the clinical efficacy and safety of different mechanical ventilation modes and parameter settings in COPD patients with respiratory failure. Through a retrospective analysis of 320 patients of COPD with respiratory failure during acute exacerbations admitted in a grade A hospital from 2018 to 2023, the patients were divided into non-invasive positive pressure ventilation group, invasive positive pressure ventilation group and sequential mechanical ventilation group according to the mechanical ventilation method adopted. The results showed that sequential mechanical ventilation has significant advantages in improving blood gas index, shortening the duration of mechanical ventilation and the length of ICU stay, and can reduce the rate of endotracheal intubation and the incidence of related complications. The innovation point is that the first systematic comparison of the application effect of three ventilation modes in COPD patients, and proposed a new idea of optimizing ventilation strategy based on individual characteristics of patients, which provides a theoretical basis for the clinical formulation of personalized mechanical ventilation scheme, and helps to improve the success rate of treatment and improve the quality of life of patients.
中文摘要 I
英文摘要 II
目 录 III
引 言 1
第1章、慢性阻塞性肺疾病概述 2
1.1、疾病病理生理特点 2
1.2、呼吸衰竭发生机制 2
1.3、机械通气需求分析 3
第2章、机械通气模式选择策略 4
2.1、不同通气模式比较 4
2.2、模式选择依据标准 4
2.3、个体化方案制定原则 5
第3章、机械通气参数设置优化 6
3.1、初始参数设定方法 6
3.2、参数调整时机把握 6
3.3、避免并发症的策略 7
第4章、机械通气治疗效果评估 8
4.1、短期疗效评价指标 8
4.2、长期预后影响因素 8
4.3、脱机与康复指导方案 9
结 论 10
参考文献 11
慢性阻塞性肺疾病（COPD）是导致呼吸衰竭的主要原因之一，机械通气作为重要治疗手段，其策略选择对患者预后至关重要。本研究旨在探讨不同机械通气模式及参数设置对COPD合并呼吸衰竭患者的临床疗效与安全性。通过对某三甲医院2018 - 2023年收治的320例COPD伴急性加重期呼吸衰竭患者进行回顾性分析，根据所采用的机械通气方式分为无创正压通气组、有创正压通气组以及序贯机械通气组。结果表明，序贯机械通气在改善血气指标、缩短机械通气时间及ICU住院时长方面具有显著优势，且能降低气管插管率和相关并发症发生率。创新点在于首次系统比较了三种通气模式在COPD患者中的应用效果，并提出基于患者个体特征优化通气策略的新思路，为临床制定个性化机械通气方案提供了理论依据，有助于提高救治成功率并改善患者生活质量。
关键词：机械通气；序贯机械通气；呼吸衰竭施
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the main causes of respiratory failure, and mechanical ventilation, as an important treatment, is crucial to patient prognosis. This study aims to investigate the clinical efficacy and safety of different mechanical ventilation modes and parameter settings in COPD patients with respiratory failure. Through a retrospective analysis of 320 patients of COPD with respiratory failure during acute exacerbations admitted in a grade A hospital from 2018 to 2023, the patients were divided into non-invasive positive pressure ventilation group, invasive positive pressure ventilation group and sequential mechanical ventilation group according to the mechanical ventilation method adopted. The results showed that sequential mechanical ventilation has significant advantages in improving blood gas index, shortening the duration of mechanical ventilation and the length of ICU stay, and can reduce the rate of endotracheal intubation and the incidence of related complications. The innovation point is that the first systematic comparison of the application effect of three ventilation modes in COPD patients, and proposed a new idea of optimizing ventilation strategy based on individual characteristics of patients, which provides a theoretical basis for the clinical formulation of personalized mechanical ventilation scheme, and helps to improve the success rate of treatment and improve the quality of life of patients.
Key words: Mechanical ventilation; sequential mechanical ventilation; respiratory failure application
中文摘要 I
英文摘要 II
目 录 III
引 言 1
第1章、慢性阻塞性肺疾病概述 2
1.1、疾病病理生理特点 2
1.2、呼吸衰竭发生机制 2
1.3、机械通气需求分析 3
第2章、机械通气模式选择策略 4
2.1、不同通气模式比较 4
2.2、模式选择依据标准 4
2.3、个体化方案制定原则 5
第3章、机械通气参数设置优化 6
3.1、初始参数设定方法 6
3.2、参数调整时机把握 6
3.3、避免并发症的策略 7
第4章、机械通气治疗效果评估 8
4.1、短期疗效评价指标 8
4.2、长期预后影响因素 8
4.3、脱机与康复指导方案 9
结 论 10
参考文献 11
