慢性阻塞性肺疾病继发急性呼吸衰竭采用无创双水平正压通气辅以呼吸兴奋剂的临床研究

Clinical Study of Non-invasive Bi-level Positive Pressure Ventilation Supplemented with Respiratory Stimulant on Chronic Obstructive Pulmonary Disease Secondary to Acute Respiratory Failure

目的研究慢性阻塞性肺疾病继发急性呼吸衰竭采用无创双水平正压通气辅以呼吸兴奋剂的临床。方法纳入研究对象为我院2017年1月至2019年3月收治的110例慢性阻塞性肺疾病继发急性呼吸衰竭患者,将其随机分为对照组和观察组。对照组采用常规治疗辅以呼吸兴奋剂。观察组在对照组方案基础上加用无创双水平正压通气。观察两组血气指标变化,总有效率、住院时间及不良反应。结果两组治疗前pH、PaCO2、PaO2及治疗24 h、72 h的pH值无显著差异(P>0.05)。两组治疗24 h及72 h的PaCO2、PaO2均比治疗前显著改善(P<0.05)。观察组治疗24 h及72 h的PaCO2、PaO2显著好于对照组(P<0.05)。观察组总有效率及住院天数显著好于对照组(P<0.05)。结论慢性阻塞性肺疾病继发急性呼吸衰竭采用无创双水平正压通气辅以呼吸兴奋剂的临床效果明显,可显著改善缺氧,促进患者恢复。

Objective To study clinical effect of noninvasive bi-level positive pressure ventilation supplemented with respiratory stimulant on chronic obstructive pulmonary disease secondary to acute respiratory failure.Methods Include 110 cases chronic obstructive pulmonary disease patients secondary to acute respiratory failure admitted to our hospital from January 2017 to March 2019 as research objects,and randomly divided them into control group and observation group.Control group was treated with routine treatment supplemented with respiratory stimulants,and bservation group was added non-invasive bi-level positive pressure ventilation on the basis of control scheme.Observe changes of blood gas indexes,total effective rate,hospital stay and adverse reactions of two groups.Results There was no significant difference in pH,PaCO2 and PaO2 between two groups before treatment and 24 h and 72 h treatment(P>0.05).PaCO2 and PaO2 of two groups was significantly better at 24 h and 72 h than before treatment(P<0.05).PaCO2 and PaO2 of observation group at 24 h and 72 h was significantly better than control group(P<0.05).Total effective rate and hospitalization days of observation group were significantly better than control group(P<0.05).Conclusion Noninvasive bi-level positive pressure ventilation combined with respiratory stimulants has significant clinical effect on chronic obstructive pulmonary disease secondary to acute respiratory failure,can improve hypoxia and promote patient recovery significantly.