超短波对辅助无创通气治疗COPD伴Ⅱ型呼吸衰竭的影响

Effects of ultrashort-wave therapy on the clinical efficacy of noninvasive ventilation in patients with typeⅡrespiratory failure caused by chronic obstructive pulmonary disease

目的观察超短波对接受无创正压通气治疗慢性阻塞性肺病(COPD)伴Ⅱ型呼吸衰竭患者的影响。方法治疗组在常规治疗及无创正压通气的基础上加用超短波治疗,微热量,每日1次。每次15min,共15d;对照组在常规治疗的基础上加用无创正压通气。对所有患者进行血氧饱和度监测,治疗前、后检测动脉血气分析指标动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)及肺的通气功能指标:用力肺活量(FVC)、第一秒用力呼气量(FEV_(1.0)),记录机械通气时间和住院时间。结果治疗组总有效率为93.3%,对照组总有效率为73.3%,治疗组总有效率明显高于对照组(P<0.05);机械通气时间治疗组为(6.2±2.6)d,对照组为(8.1±3.0)d,住院时间治疗组为(17.8±2.5)d,对照组为(19.2±3.0)d,上述指标2组比较,差异有统计学意义(P<0.05);动脉血气分析结果治疗组明显优于对照组(P<0.05),治疗组肺功能改善明显高于对照组(P<0.05)。结论超短波辅助无刨正压通气治疗COPD伴Ⅱ型呼吸衰竭患者可提高临床疗效,减少患者机械通气时间和住院时间,改善患者缺氧状态及肺的通气功能。

Objective To study the effects of ultrashort-wave therapy on the clinical efficacy of noninvasive positive pressure ventilation（NPPV） in chronic obstructive pulmonary disease（COPD） with type Ⅱ respiratory failure. Methods A total of 60 patients were studied. Thirty patients in the control group received conventional thera- py and NPPV, an the other 30 patients in the treatment group were treated with ultrashort-wave therapy once a day in addition to the conventional therapy and NPPV. The treatment lasted for 15 days. Arterial oxygen saturation （SaO2） was continuously monitored in all patients, arterial blood gas values such as PaO2 and PaCO2 and pulmonary function such as FVC and FEV1-0 were measured before and after treatment, the duration of ventilation and hospitalization were recorded. Results The total effective rate in the treatment group was significantly higher than that in the control group （93.3% vs 73.3% , P 〈 0. 05 ）. The duration of ventilation and hospitalization were （6.2 ± 2.6） and （ 17.8 ±2.5）days in the treatment group, and （8. 1 ± 3.0） and （ 19.2 ± 3.0） days in the control group, respectively, showing that there was significant difference between the two groups （ P 〈 0.05 ）. The arterial blood gas values and pulmonary function in the treatment group were improved to a significantly greater extend than that in the control group （P 〈0.05）. Conclusion Ultrashort-wave therapy could help increase therapeutic effects of NPPV, shorten the duration of hospitalization and ventilation, and improve hypoxia and pulmonary function in the patients with type Ⅱ respiratory failure caused by COPD.