摘要
目的:对无创机械通气联合中药治疗老年慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效及安全性进行观察和评价。方法:选取100例老年COPD合并Ⅱ型呼吸衰竭患者作为研究对象,将其随机分成观察组和对照组,每组各50例。对两组患者均给予抗感染、止咳化痰等对症治疗,对照组患者在此基础上给予双相正压无创机械通气治疗,观察组患者在对照组疗法的基础上联合应用中药进行治疗。对两组患者治疗前、治疗后的动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)的变化情况、血气改善时间、不良反应进行观察和分析。结果:两组患者治疗后的PaO2较治疗前显著提高(P<0.05),PaCO2较治疗前显著降低(P<0.05),且观察组的改善程度大于对照组(P<0.05);两组患者在血气改善时间方面的差异无显著统计学意义(P>0.05);两组患者均未发生呼吸机相关肺部感染、肝肾功能异常等严重不良反应。结论:使用无创机械通气联合中药治疗老年COPD合并II型呼吸衰竭患者的疗效优于单独使用无创机械通气进行治疗,其改善血气指标的作用更加显著,而且安全性较高,值得在临床上推广应用。
Objective:To observe and evaluate the effects and safety of non - invasive mechanical ventilation combined with traditional Chinese medicine in treatment of the elderly patients with chronic obstructive pulmonary disease (COPD)complicated with type Ⅱ respiratory failure. Methods : 100 patients with COPD complicated with type Ⅱ respiratory failure were selected as the research objects and randomly divided into the observation group and the control group. 50 cases were included into each group. The patients in the two groups were treated with anti-infection, relieving cough and phlegm and other symptomatic treatments. The patients in the control group were treated with the double phase positive pressure noninvasive mechanical ventilation on the basis of the above treatment, while the patients in the observation group were treated with combined treatment of traditional Chinese medicine on the basis of the treatment of the control group. The changes of arterial partial pressure of oxygen ( PaO2 ), arterial partial pressure of carbon dioxide ( PaCO2 ) before and after the treatment, the time for blood gas indexes to improve and the adverse reactions of the patients in the two groups were observed and analyzed. Results : The PaO2 levels of the patients in the two groups after treatment increased significantly compared with those before treatment ( P 〈 0. 05 ) ; PaCO2 levels after treatment decreased significantly compared with those before treatment( P 〈 0. 05 ) ;the degrees of improvement in the observation group were higher than those in the control group ( P 〈 0. 05 ) ; there was no significant difference of the time for blood gas to improve between the two groups ( P 〉 0. 05 ) ;in the patients of the two groups, the serious adverse reactions such as ventilator - associated lung infection, liver and kidney dysfunction were not observed. Conclusion : The curative effects of non - invasive mechanical ventilation combined with traditional Chinese medicine treatment on the elderly patients with COPD complicated with type Ⅱ respiratory failure are better than those of the single use of noninvasive mechanical ventilation for treatment. The more pronounced effects are observed on the improvement of blood gas indexes and higher safety is obtained. The treatment is worthy of clinical application.
出处
《辽宁中医杂志》
CAS
2013年第11期2309-2311,共3页
Liaoning Journal of Traditional Chinese Medicine
关键词
无创机械通气
慢性阻塞性肺疾病
Ⅱ型呼吸衰竭
中西医结合治疗
疗效观察
noninvasive mechanical ventilation
chronic obstructive pulmonary disease
type Ⅱ respiratory failure
treatment of traditional Chinese and Western medicine
curative effect observation