BiPAP联合特布他林-氨溴索雾化吸入治疗AECOPD合并Ⅱ型呼吸衰竭患者的疗效观察

Clinical effects observation of BiPAP combined with inhalation Terbutaline plus Ambroxol in the treatment of AECOPD patients with type Ⅱrespiratory failure

目的观察双水平气道正压通气(BiPAP)联合特布他林-氨溴索雾化吸入对AECOPD合并Ⅱ型呼吸衰竭的临床疗效。方法选取我院2008年10月—2011年10月间AECOPD合并Ⅱ型呼吸衰竭84例,分成A组(43例)、B组(41例),进行临床分析。两组均常规给予吸氧、祛痰、平喘、抗感染等治疗,A组同时给予BiPAP通气;B组给予BiPAP通气联合特布他林-氨溴索雾化吸入。观察患者治疗前后血气分析、心率、呼吸频率改变及平均住院天数、气管插管率、病死率的情况。结果两组在治疗后血气分析、HR、RR情况较治疗前均显著改善(P<0.01),而B组在治疗前后改善情况明显优于A组,具有显著统计学差异(P<0.05);两组总有效率比较,无统计学差异(P>0.05),其中显效率B组高于A组,有统计学差异(P<0.05);而在平均住院天数方面,B组明显优于A组(P<0.05)。结论对于AECOPD合并Ⅱ型呼吸衰竭患者采用BiPAP通气联合特布他林-氨溴索雾化吸入治疗,其疗效优于单一采用BiPAP治疗。

Objective To evaluate the clinical effects of Bi-level positive airway pressure（BiPAP） combined with inhalation Terbutaline plus Ambroxol in the treatment of acute exacerbation chronic obstructive pulmonary disease（AECOPD） patients with type Ⅱ respiratory failure. Methods Eighty four AECOPD patients with type Ⅱ respiratory failure in our hospital from October 2008 to October 2011 were divided into group A（43 cases） and group B（41 cases） and clinically analyzed.The routine treatment including oxygen inhalation,eliminating phlegm,relieving asthma,anti-infection and BiPAP was given to patients in both groups,while inhalation Terbutaline plus Ambroxol was added to patients in group B.The blood gas analysis,HR and RR before and after treatment as well as days of hospitalization,intubation rate and mortality were observed. Results Blood gas analysis,HR and RR of the patients in two groups were significantly improved（P0.01） and the improvement in group B was much superior to that of the patients in group A with obvious statistic difference（P0.05）;there was no significant difference between the two groups in the total effective rate（P0.05）,but the excellence rate of group B was higher and has statistical significance with that of group A（P0.05）;The duration in hospital was shorter in the group B than that in the group A（P0.05）. Conclusion BiPAP combined with inhalation Terbutaline plus Ambroxol is better than BiPAP treatment alone in the treatment of AECOPD patients with type Ⅱ respiratory failure.