床旁纤支镜吸痰联合无创通气治疗COPD并呼吸衰竭疗效观察

Effect of bedside Bronchofiberscope sputum suction combined with non-invasive positive pressure ventilation in the treatment of respiratory failure in COPD patients

目的探讨床旁应用纤支镜吸痰联合无创正压通气(NIPPV)在救治慢性阻塞性肺疾病(COPD)并发Ⅱ型呼吸衰竭中的应用价值。方法 81例COPD并发呼吸衰竭患者随机分为两组,治疗组在床旁监护下应用纤支镜常规检查并充分吸痰,吸痰完毕后接面罩进行NIPPV,对照组则单纯给予NIPPV治疗,同时记录治疗前后动脉血气分析、血常规、胸片等指标。结果治疗组治疗成功41例,成功率89.13%;对照组治疗成功24例,成功率68.57%,两组比较差异有统计学意义(χ2=5.30,P<0.05)。同时治疗组在改善PaO2、PaCO2、SaO2等方面优于对照组,差异具有统计学意义(P<0.05)。结论纤支镜吸痰联合无创通气治疗能有效解除气道梗阻,改善通气,值得临床广泛应用。

Objective To observe the value of bronchofiberscope sputum suction combined with non-invasive positive pressure ventilation （NIPPV） in the treatment of respiratory failure in chronic obstructive pulmonary disease （COPD） pa- tients. Methods All of 81 COPD patients of respiratory failure were randomly divided into two groups. The patients in treatment group were treated with the bedside bronchofiberscope sputum suction under the careful observation, after that the patients received NIPPV by mask. The patients in the control group were treated only with NIPPV. Meanwhile,the re- sults of arterial blood gas, complete blood cell, chest X-ray and other examinations were recorded before and after treat- ment. Results In treatment group, 41 cases were treated successfully, the rate of success was 89.13%. In control group, 24 cases were treated successfully, the rate of success was 68.57%. The difference between the two groups was significant （P 〈 0.05）. Meanwhile, the treatment group was better than control group in the improving of PaO2, PaCO2, Sa02, the difference between the two groups was significant （P 〈 0.05）. Conclusion Bronehofiberscope sputum suction combined with non-in- vasive positive pressure ventilation is effective in relieving the airway obstruction and improving the ventilation. The tech- nique is worth application.