BiPAP无创通气联合痰热清注射液治疗慢性阻塞性肺疾病急性呼吸衰竭疗效观察

Curative Effect of BiPAP Ventilator combined Tan Re Qing injection for COPD with Respiratory Failure Treatment

目的探讨BiPAP无创通气联合痰热清注射液治疗慢阻肺急性呼衰的临床疗效。方法83例慢性阻塞性肺病急性加重期并发Ⅱ型呼吸衰竭的患者按照入院先后顺序随机分为3组:A组(常规治疗组27例)、B组(在常规治疗组基础上加用BiPAP无创通气28例)、C组(在B组基础上联合痰热清注射液治疗28例)。常规组以消炎、祛痰、平喘、抗感染及持续低流量吸氧对症支持治疗,无创通气组通气模式为压力支持(PSV)加呼气末正压(PEEP),C组在B组治疗基础上同时给予痰热清注射液20 ml加入5%葡萄糖注射液250 ml静脉滴注,1次/d,疗程10 d。观察3组患者治疗前与治疗后2 h、48 h血气分析、呼吸频率、心率及转归情况比较。结果无创通气加痰热清注射液组在治疗后2 h及48 h后PaO2、PaCO2、pH和呼吸、心率均明显改善(P<0.05),而常规治疗组无明显改善。结论 BiPAP无创通气联合痰热清注射液治疗慢阻肺急性加重期并发Ⅱ型呼吸衰竭能明显改善临床症状,降低死亡率,值得临床推广和应用。

To observe the effects of no hurt BiPAP ventilator combined Tan Re Qing injection for COPD with respiratory failure treatment. Methods 83 cases were divided into three groups. A group （27 cases of con ventional treatment group） ,B group（ On the basis of conventional therapy group and BiPAP noninvasive venti lation in 28 cases） ,C group （ In the B group based on the combined with Tan reqing Injection in the treatment of 28 cases）cases in control were given antiinfection, eliminating phlegm, relieving asthma and continuously in haling low concentration oxygen. Cases in aeration group were treated with BiPAP respire meter, noninvasive ventilation model for the pressure support and positive （PSV） end expiratory pressure （ PEEP）, group C while giving treatment Tan Re Qing on the basis of the group B. Once a day, 10 days for a course of treatment. The three groups were observed before treatment and after treatment for 2 hours, 48 hours of blood gas analysis, re spiratory rate, heart rate and prognosis of comparison. Results The results showed that routine treatment com bined with Bi PAP respire meter and Tan Re Qing injection 2 and 48 hours after PaO2, PaCO2, pH and breath ing, heart rate were improved significantly （ P 〈 0.05 ）, and conventional treatment group had no obvious im provement. Conclusion Curative effect of of BiPAP Ventilator combined Tan Re Qing injection for COPD with type H respiratory failure treatment was good. Conclusions, decrease the mortality rate, worthy of clinical popu larization and Application.