经面罩无创机械通气治疗慢性阻塞性肺疾病合并重症呼吸衰竭138例临床研究

Noninvasive Mechanical Ventilation in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Severe Respiratory Failure Clinical Study of 138 Cases with Face Mask

目的分析研究经面罩无创机械通气的方法在治疗慢性阻塞性肺疾病合并重症呼吸衰竭方面的临床效果。方法选取四川省盐源县人民医院呼吸科收治的慢性阻塞性肺疾病合并重症呼吸衰竭的患者138例为研究对象,随机分为观察组和对照组,各69例。对照组采用常规化痰、抗感染等治疗,观察组采用经面罩无创机械通气的方法治疗,对比两组患者的预后结局,评价经面罩无创机械通气的治疗效果。结果观察组治疗总有效率95.7%,显著高于对照组的82.6%,组间对比差异有统计学意义(P<0.05);观察组出现并发症2例,其中腹部肿胀患者1例、面罩压迫性皮肤损伤者1例,并发症发生率为2.9%,死亡率1.4%,平均住院时间(16.1±2.7)d;对照组并发症发生率10.1%,死亡率7.2%,平均住院时间(20.6±2.1)d。结论采用无创机械通气治疗慢性阻塞性肺疾病合并重症呼吸衰竭患者,可以提高临床治疗有效率,降低并发症的发生,降低死亡率,缩短病程。

Objective To analyze the clinical effects of noninvasive mechanical ventilation via face mask in the treatment of chronic obstructive pulmonary disease complicated with severe respiratory failure.Methods 138 cases were selected from the department of respiration in People's hospital of yanyuan county,sichuan province with chronic obstructive pulmonary disease complicated with severe respiratory failure as the research object.They were randomly divided into observation group and control group,69 cases in each group.Control group received conventional phlegm,anti infection treatment.Observation group was given noninvasive mechanical ventilation via face mask treatment.Outcomes were compared between two groups.Therapeutic effects of noninvasive mechanical ventilation via face mask were evaluated.Results The total efficiency of the observation group was 95.6%,which was significantly higher than 82.6%in the control group.The difference was significant(P<0.05).There were 2 cases with complications in the observation group,including 1 case of a patient with abdominal swelling and 1 case of skin injury mask oppression.The complication rate was 2.9%.The mortality rate was 1.4%.The average hospitalization time was(16.1±2.7)d.The incidence rate of complications was 10.1%in the control group.The mortality rate was 7.2%and the average hospitalization time was(20.6±2.1)d.Conclusion Treating chronic obstructive pulmonary disease in patients with severe respiratory failure by the noninvasive mechanical ventilation can improve clinical efficiency,reduce complications,reduce the mortality and shorten the course of disease.