探讨有创-无创序贯机械通气联合纳美芬治疗重度Ⅱ型呼吸衰竭临床效果。

选取2018年10月至2020年2月我院诊治60例重度Ⅱ型呼吸衰竭患者，将患者用随机分为常规组28例(有创-无创序贯机械通气治疗)和研究组32例(有创-无创序贯机械通气治疗联合纳美芬治疗)。比较两组患者血气水平、神经功能损伤情况、生命体征、有创通气治疗时间、ICU住院时间和总住院时间，及相关并发症发生率。

(1)组内比较，两组治疗前、治疗1、3、5 d的氧分压(PaO₂)水平、酸碱度(pH)值、GCS评分、动脉收缩压升高，二氧化碳分压(PaCO₂)水平、自主呼吸频率、心率均降低(P<0.05)。组间比较，两组治疗前血气分析指标、GCS评分、自主呼吸频率、心率及动脉收缩压均无明显差异(P>0.05)；研究组治疗1、3、5 d的PaO₂水平、GCS评分、动脉收缩压高于常规组，PaCO₂水平、自主呼吸频率、心率低于常规组(P<0.05)；两组治疗1、3、5 d的pH值无明显差异(P>0.05)；(2)研究组有创通气时间、总机械通气时间、住重症监护室时间、总住院时间低于常规组(P<0.05)；(3)研究组VAP发生率、再插管率发生率均低于常规组(3.57% vs. 28.13%，0.00% vs. 18.75%)，P<0.05。

有创-无创序贯机械通气联合纳美芬治疗重度Ⅱ型呼吸衰竭，具有显著临床疗效。

To investigate the clinical effects of invasive-non-invasive sequential mechanical ventilation combined with nalmefene in the treatment of severe type Ⅱ respiratory failure.

Selected from 2018-10-2020-02 in our hospital to diagnose and treat 60 cases of severe type Ⅱ respiratory failure to implement research, Use the randomized grouping table to divide into the conventional group (invasive-noninvasive sequential mechanical ventilation treatment, 28 cases) and the research group (invasive-noninvasive sequential mechanical ventilation treatment combined with nalmefene treatment, 32 cases). The blood gas levels, neurological damage, vital signs, invasive ventilation treatment time, ICU hospital stay and total hospital stay, and the incidence of related complications were compared between the two groups.

(1) Comparison of PaO₂ (oxygen partial pressure) level, pH (pH) value, GCS score, arterial systolic blood pressure, and PaCO₂ (carbon dioxide partial pressure) before treatment, 1 day, 3 days, and 5 days after treatment. Level, spontaneous respiratory rate, and heart rate were all decreased (P<0.05). There were no significant differences in blood gas analysis index, GCS score, spontaneous respiratory rate, heart rate and arterial systolic pressure between the two groups before treatment (P>0.05). The PaO₂ level, GCS score, and arteries of the experimental group at 1 d, 3 d, and 5 d were treated. The systolic blood pressure was higher than that of the control group, PaCO₂ level, spontaneous respiratory rate and heart rate were lower than the control group (P<0.05). There was no significant difference in pH value between the two groups at 1 d, 3 d and 5 d (P>0.05). (2) The study group′s invasive ventilation time, total mechanical ventilation time, stay in intensive care unit, and total hospital stay were lower than those in the conventional group (P<0.05). (3) The incidence of VAP and reintubation in the study group were lower than those in the conventional group [3.57% vs. 28.13%, 0.00% vs. 18.75%, P<0.05].

Invasive-noninvasive sequential mechanical ventilation combined with nalmefene in the treatment of severe type Ⅱ respiratory failure has significant clinical effects.