无创通气联合信必可治疗老年慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭临床效果观察

Clinical efficacy of non-invasive ventilation combined with Symbicort in elderly patients with chronic obstructive pulmonary disease with acute exacerbation and type Ⅱ respiratory failure

目的观察无创通气联合信必可治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的临床效果。方法选取淮北市人民医院自2015年11月至2019年12月收治的100例AECOPD合并Ⅱ型呼吸衰竭老年患者为研究对象。将患者随机分入A组和B组,每组各50例。A组采用无创通气治疗,B组在A组基础上联合应用信必可。比较两组患者治疗前和治疗3 d后的肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC]、血气指标[pH、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)]、心率、呼吸频率、收缩压,以及治疗期间的不良反应发生情况。结果治疗前,A组、B组FVC、FEV1、FEV1/FVC、pH、PaO2、PaCO2、心率、呼吸频率、收缩压比较,差异均无统计学意义(P>0.05)。治疗后,A组、B组FVC、FEV1、FEV1/FVC、pH、PaO2均高于治疗前,且B组高于A组,差异有统计学意义(P<0.05);A组、B组PaCO2、心率、呼吸频率、收缩压均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。治疗期间,B组不良反应发生率低于A组,差异有统计学意义(P<0.05)。结论无创通气联合信必可治疗老年AECOPD合并Ⅱ型呼吸衰竭临床效果显著,可改善患者的肺功能和血气指标,降低心率、呼吸、收缩压,且安全性高。

Objective To investigate the clinical effect of non-invasive ventilation combined with Symbicort in the treatment of acute exacerbation of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and typeⅡrespiratory failure in elderly patients.Methods A retrospective study was performed on 100 cases of elderly patients with AECOPD combined with typeⅡrespiratory failure who were admitted from November 2015 to December 2019.Patients were randomly divided into the Group A and Group B,with 50 cases in each group.Patients of Group A were treated with non-invasive ventilation,the others of Group B were added Symbicort combined with non-invasive ventilation.Two groups of patients of pulmonary function before and after treatment for 3 days index[forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),(FEV1/FVC)],blood gas index[pH,arterial blood oxygen partial pressure(PaO2),arterial carbon dioxide partial pressure(PaCO2)],heart rate,respiratory rate,systolic blood pressure,and the adverse reactions occurred during treatment were compared.Results Before treatment,there were no significant differences in FVC,FEV1,FEV1/FVC,pH,PaO2,PaCO2,heart rate,respiratory rate and systolic blood pressure between Group A and Group B(P>0.05).After the treatment,FVC,FEV1,FEV1/FVC,pH and PaO2 in Group A and B were all higher than before treatment,and Group B was higher than Group A,with statistically significant differences(P<0.05).PaCO2,heart rate,respiratory rate and systolic blood pressure in Group A and Group B were all lower than before treatment,and Group B was lower than Group A(P<0.05).During the treatment,the incidence of adverse reactions in Group B was lower than that in Group A(P<0.05).Conclusion Non-invasive positive ventilation combined with Symbicort in the treatment of AECOPD and typeⅡrespiratory failure can improve the pulmonary function and blood gas index of patients,reduce the heart rate,respiration and systolic blood pressure,with obvious effect and high safety.