早期无创正压通气治疗慢性阻塞性肺疾病急性加重期患者的临床研究

Clinical Study on the Treatment of Early Noninvasive Positive Pressure Ventilation in Patients with Acute Exacerbation Chronic Obstructive Pulmonary Disease

目的:观察早期应用无创正压通气(NPPV)治疗慢性阻塞性肺疾病(COPD)急性加重期患者的临床疗效及安全性。方法:选择2012年11月-2013年4月本院呼吸科收治的COPD急性加重期患者28例,按随机数字表法分为NPPV组和对照组,每组各14例。对照组患者接受常规药物治疗,治疗组在常规药物治疗的同时,采用NPPV治疗,首次治疗时间2 h,每日累计治疗时间8 h以上。观察两组患者治疗后各时间段的各项生理指标,包括动脉血氧分压(PaCO2)呼吸频率(RR)、心率(HR)、辅助呼吸肌评分、插管率及死亡率。结果:治疗后,治疗组PaCO2、RR、HR、辅助呼吸肌评分及插管率与对照组相比,差异均有统计学意义(P<0.05);治疗组死亡率为4.9%,低于对照组的5.4%,但差异无统计学意义(P>0.05)。结论:早期应用NPPV治疗COPD急性加重期患者能显著改善患者的各项生理指标,缓解病情,适当降低死亡率。

Objective：To observe the clinical efficacy and the safety of early noninvasive positive pressure ventilation（NPPV） in patients with acute exacerbation chronic obstructive pulmonary disease（COPD）.Method：28 patients with acute exacerbation COPD from Nov 2012 to Apr 2013 in our hospital were divided into the control group and the treatment group according to random number table method,each group with 14 patients,the control group was given conventional drug treatment,the treatment group was given NPPV besides conventional drug treatment,the first treatment time was 2 hours,the total time was 8 hours every day.Arterial partial pressure of oxygen（PaCO 2）,breathing rate,heart rate,accessory respiratory muscle score,intubation rate and death rate before and after treatment were observed.Result：All the physiological parameters of the two groups before treatment had no statistical significance（P〉0.05）.PaCO 2,breathing rate,heart rate,accessory respiratory muscle score,intubation rate of the two groups after treatment had statistical significance（P〈0.05）,the death rate of treatment group（4.9%） was lower than control group（5.4%）,the difference had no statistical significance（P〉0.05）.Conclusion：Early NPPV in patients with acute exacerbation COPD improves the patients＇ situation,reduce death rate.