无创正压通气在伴随轻度肺性脑病的AECOPD患者中的应用效果及对其精神状态的影响

Effects of NIPPV on AECOPD patients with mild pulmonary encephalopathy and its influence on patients'mental state

目的 探讨无创正压通气应用于慢性阻塞性肺疾病急性加重期(AECOPD)伴轻度肺性脑病患者的临床效果及其对患者精神状态的影响.方法 选择西山煤电(集团)有限责任公司职工总医院2016年1月至2018年12月收治的AECOPD伴轻度肺性脑病患者82例为研究对象,按照随机数字表法将其分为研究组41例和对照组41例.对照组行临床常规治疗,研究组在对照组治疗基础上加用无创正压通气治疗.比较两组患者的肺功能、血气分析指标及精神状态变化情况.结果 治疗前,两组pH、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、呼气峰流速(PEF)及格拉斯哥昏迷指数评分(GCS)比较,差异均未见统计学意义(P均>0.05);治疗后,研究组pH、PaO2、PEF、GCS评分较治疗前的提高幅度优于对照组(P<0.05),治疗后研究组PaCO2较治疗前的下降幅度优于对照组(P<0.05).结论 应用无创正压通气可显著提高AECOPD伴轻度肺性脑病患者的临床疗效,有利于改善其精神状态.

Objective To investigate the effects of noninvasive positive pressure ventilation(NIPPV)on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with mild pulmonary encephalopathy and its influence on mental state.Methods Eighty-two patients with AECOPD and mild pulmonary encephalopathy admitted to the General Staff Hospital of Xishan Coal andElectricity Group from January 2016 to December 2018 were selected as the study subjects.According to the random number table method,41 cases were allocated into the study group and 41 cases were enrolled in the control group.The control group received routine clinical treatment,while the study group received NIPPV on the basis of treatment of the control group.The changes of pulmonary function,blood gas analysis index and mental state were compared between the two groups.Results Before treatment,there were no significant differences in pH,partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),peak expiratory flow(PEF)or Glasgow coma scale(GCS)score between the two groups(P>0.05).After treatment,the scores of pH,PaO2,PEF and GCS in study group were better than those in control group(P<0.05),and the decrease in PaCO 2 in study group was better than that in control group(P<0.05).Conclusions NIPPV can significantly improve the treatment effects on AECOPD patients with mild pulmonary encephalopathy and improve patients'mental state.