无创机械通气在慢性阻塞性肺疾病并呼吸衰竭患者中的应用效果

Application Effect of Non-invasive Mechanical Ventilation in the Treament of Patients with COPD Complicated with Respiratory Failure

目的探讨无创机械通气在慢性阻塞性肺疾病(COPD)并呼吸衰竭患者中的应用效果。方法选取广州医科大学附属第二医院2016年3—11月收治的COPD并呼吸衰竭患者100例,按照随机数字表法分为对照组和观察组,各50例。对照组患者给予常规治疗,研究组患者在对照组基础上给予无创机械通气治疗。比较两组患者治疗前及治疗后3个月肺功能指标[包括第1秒用力呼气容积(FEV1)、FEV1/FVC、第1秒用力呼气容积占预计值百分比(FEV1%)及最大呼气流量(PEF)]及血清C反应蛋白(CRP)、可溶性细胞间黏附分子1(sICAM-l)、前白蛋白(PA)水平。结果两组患者治疗前FEV1、FEV1/FVC、FEV1、PEF比较,差异无统计学意义(P>0.05);研究组患者治疗后3个月FEV1、FEV1/FVC、FEV1%、PEF高于对照组(P<0.05)。研究组患者治疗后3个月血清CRP、sICAM-1水平低于对照组,血清PA水平高于对照组(P<0.05)。结论无创机械通气可有效改善COPD并呼吸衰竭患者肺功能,减轻炎性反应,提高机体免疫力。

Objective To explore the application effect of non-invasive mechanical ventilation in the treament of patients with COPD complicated with respiratory failure.Methods From March to November 2016,100 cases of COPD patients complicated with respiratory failure were selected in the Second Affiliated Hospital of Guangzhou Medical University,and they were divided into the control group and the observation group,50 cases in each group.Patients in the control group were treated with conventional methods,and patients in the observation group were treated with non-invasive mechanical ventilation on the basis of the control group.Lung function indexes(including FEV1,FEV1/FVC,FEV1%,PEF)before treatment and 3 months after treatment,levels of CRP,sICAM-1 and PA 3 months after treatment were compared between the two groups.Results No signidicant difference of FEV1,FEV1/FVC,FEV1%or PEF between the two groups before treatment(P>0.05);FEV1,FEV1/FVC,FEV1%,PEF in observation group were higher than those in control group 3 months after treatment(P<0.05).Serum levels of CRP,sICAM-1 in the observation group were lower than those in control group,serum PA level in the observation group was higher than that in control group 3 months after treatment(P<0.05).Conclusion Non-invasive mechanical ventilation can effectively improve lung function,relief inflammatory reaction and promote immune function of COPD patients complicated with respiratory failure.