NPPV对AECOPD合并重度Ⅱ型呼吸衰竭患者PaO_(2)及pH值的影响分析

Effect of NPPV on PaO_(2) and pH value in patients with AECOPD combined with severe type Ⅱ respiratory failure

【目的】分析无创正压通气(non-invasive positive pressure ventilation,NPPV)对急性加重期慢性阻塞性肺疾病(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并重度Ⅱ型呼吸衰竭患者PaO2及pH值的影响。【方法】选择2017年1月至2018年12月本院收治的以AECOPD合并重度Ⅱ型呼吸衰竭为诊断,并行NPPV治疗的79例患者为实验组,另选取同期同诊断未使用NPPV,仅采取常规吸氧治疗的79例患者为对照组。对比2组患者治疗前、后血气相关指标(pH值、PaO2、PaCO2、SaO2)、肺功能相关指标[肺活量(vital capacity,VC)、用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)、FEV1/FVC]、生命体征(心率、体温、呼吸)、临床治疗效果、并发症与气管插管发生情况。【结果】治疗后,2组患者血气指标、肺功能指标、生命体征相关指标较治疗前均有明显改善,其中实验组患者pH值、PO2、SaO2及肺功能各项指标明显高于对照组,而PCO2指标明显低于对照组;实验组总有效率为97.47%,高于对照组的82.28%;实验组并发症发生率为1.27%,气管插管发生率为1.27%,明显少于对照组的12.66%、16.46%(P<0.01)。【结论】在AECOPD合并重度Ⅱ型呼吸衰竭患者的治疗中,运用NPPV可明显改善患者血气指标与肺功能,尤其是PaO2及pH值,稳定生命体征,提高临床治疗效果,并减少并发症与气管插管发生率。

【Objective】To analyze the effect of non-invasive positive pressure ventilation(NPPV)on PaO2 and pH value in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with severe typeⅡrespiratory failure.【Methods】From January 2017 to December 2018,79 patients with AECOPD and severe typeⅡrespiratory failure in our hospital undergoing NPPV treatment were selected as the experimental group,and 79 patients during the same period with the same diagnosis without NPPV,only undergoing regular oxygen treatment were selected as the control group.The pre-treatment and post-treatment blood gas indicators(pH,PaO2,PaCO2,SaO2),forced vital capacity(VC),forced expiratory capacity(FVC),and forced expiratory volume in the first second(FEV1),FEV1/FVC,vital signs(heart rate,body temperature,respiration),clinical efficacy,complications and occurrence of endotracheal intubation were compared between the two groups.【Results】After treatment,blood gas indexes,lung function indexes and vital sign indexes of patients in both groups were significantly improved compared with those before treatment.The pH,PO2,SaO2 and lung function indexes of patients in the experimental group were significantly higher than those in the control group,while PCO2 indexes were significantly lower than those in the control group.The total effective rate in the experimental group was 97.47%,higher than 82.28%in the control group.The incidence of complications and endotracheal intubation in the experimental group was 1.27%and 1.27%,which were significantly lower than those in the control group(12.66%and 16.46%,P<0.01).【Conclusion】In patients with AECOPD and severe typeⅡrespiratory failure,NPPV can obviously improve blood gas indexes and pulmonary function,especially PaO2 and p H value,stablize vital signs,improve the effect of clinical treatment,and reduce the incidence of complications and endotracheal intubation.