关键词: 肺疾病, 慢性阻塞性, P-SIMV, V-SIMV

Abstract: Objective: To investigate the clinical application of (V-SIMV and P-SIMV) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in initial invasive mechanical ventilation.Methods: Eighty-six patients with ACOPD combined with respiratory failure were randomly divided into control group (V-SIMV) and observation group (P-SIMV) in invasive mechanical ventilation with 44 cases and 42 cases respectively .At the initial time,V-SIMV+PSV was used in the control group and P-SIMV+PSV in the observation group.The peak airway pressure (Ppeak), mean airway pressure (Pmean), support pressure (PS), PH value, arterial partial pressure of carbon dioxide (PaCO₂)and effective rate were compared between the two groups 2, 4 and 8 hours after initial invasive mechanical ventilation.Results: ① The Ppeak, Pmean and PaCO₂ in the observation group were significantly lower than those in the control group, and the Vte and pH values were significantly higher than those in the control group (P<0.05).PS was slightly higher than that in the control group, but the difference was not statistically significant (P>0.05).After 8 hours, there was statistical difference between the two groups of Ppeak and Pmean, but there was no significant difference in PS, Vte, pH and PaCO₂.② The chi-square test of two independent samples showed that the effective rate of the observation group (42/42) was 100%; the control group (32/44) 72.7%;12 cases(27.3%) were changed the mode, P≤0.001, and the difference was statistically significant. There were no deaths and discharged patients in the two groups.Conclusion: P-SIMV is more suitable for initial invasive mechanical ventilation in patients with AECOPD,and can improve the effectiveness of initial mechanical ventilation in these patients.

Key words: pulmonary disease, chronic obstructive, P-SIMV, V-SIMV