慢性阻塞性肺疾病患者家庭应用无创机械通气疗效观察

Effect observation of for patients with chronic obstructive pulmonary disease

目的探讨家庭应用无创机械通气(DNPPV)对慢性阻塞性肺疾病(COPD)患者生活质量、运动耐量、肺功能及医疗费用的影响。方法将45例COPD合并Ⅱ型呼吸衰竭患者随机分为治疗组19例和对照组26例。2组于医院应用无创辅助通气治疗缓解后出院。治疗组继续应用DNPPV治疗,对照组停止无创机械通气治疗。12个月后比较2组血气指标、肺功能、6min步行距离(6WMD)及急性发作住院次数、住院费用。结果出院12个月后,治疗组患者6MWD长于对照组,治疗组PaCO2低于对照组,PaO2、FEV1高于对照组,差异均有统计学意义(P<0.05)。急性发作住院次数及医疗费用少于对照组,差异均有统计学意义(P<0.05)。结论应用DNPPV能延缓COPD患者肺功能下降速度,减少医疗费用,减少住院次数,提高生存质量。

Objective To investigate the effect of home noninvasive mechanical ventilation for patients with chronic obstructive pulmonary disease （ COPD）, including the quality of family life, exercise capacity, lung function and health care costs. Methods 45 cases of COPD patients with type II respiratory failure were randomly divided into treatment group（26 ca- ses） and control group（ 19 cases）. Two groups discharged after remission by noninvasive assisted ventilation in the hospital. Treatment group was given with DNPPV. Control group stopped noninvasive mechanical ventilation. After 12 months, compared the blood gas index,lung function,6min walking distance（6WMD） ,acute episodes of hospitalization and hospital costs of two groups. Results The 6MWD of treatment group was longer than control group, the PaCO2 of treatment group was lower than control group,the PaO2 and FEV1 of treatment group were higher than control group,the acute attack hospitalization and medi- cal expenses of treatment group were lower than control group, the differences were statistically significant（ P 〈 0.05 ）. Conclu- sion DNPPV can slow the rate of decline of lung function, reduse medical costs, and improve quality of life in patients with COPD.