无创呼吸机对慢性阻塞性肺病急性加重期的疗效观察

Observation of noninvasive ventilation therapeutic effect on acute exacerbation of chronic obstructive pulmonary disease

目的探讨无创呼吸机对慢性阻塞性肺疾病急性加重期(AECOPD)(不伴呼吸衰竭)的患者症状、体征、血气分析和肺功能的影响。方法48例患者随机分为常规治疗组(对照组)和常规治疗加无创呼吸机组(试验组)各24例。两组入院期间均给予常规抗感染﹑吸氧﹑化痰和平喘对症治疗。平喘治疗包括氨茶碱、雾化治疗等;试验组同时加用无创呼吸机治疗。结果试验组临床症状及体征评分改善明显;两组治疗前血气分析和肺功能无明显差异;治疗后试验组血气分析PO2、PCO2和PH较治疗前差异有显著性;两组肺功能较治疗前均有改善。试验组较对照组第一秒用力呼气容积(FEV1)﹑用力肺活量(FVC)﹑第一秒用力呼气容积/用力肺活量(FEV1/FVC)和第一秒用力呼气容积占预计值百分比(FEV1%Pred)等明显改善,差异有显著性。结论无创呼吸机可以看作做为慢性阻塞性肺病急性加重期的常规治疗。

Objective To investigate the clinic effect of noninvasive ventilation on patients of acute exacerbation of chronic obstructive pulmonary （AECOPD） （no respiratory failure）about symptoms,signs,blood gas analysis and lung function. Methods The total of 48 patients of AECOPD were divided into two groups at random：Experimental group（24 cases）and control group（24 cases）.The routine therapy was only given in the control group, but noninvasive ventilation and the routine therapy both were given in the experimental group. Results Scores of clinic symptoms and signs improved better;Before treatment,blood gas analysis and lung function in both groups are not statistically different （P〉0.05）.After treatment,there was improvement of blood gas analysis and lung function than before treatment （P〈0.05）.FEV1,FVC,FEV1/FVC and FEV1%Pred were superior in experimental group to control group. Conclusion noninvasive positive pressure ventilation is regard as conventional therapy of AECOPD.