无创机械通气治疗慢性阻塞性肺疾病并发呼吸衰竭的疗效观察

Efficacy of the Noninvasive Mechanical Ventilation in the Treatment of Chronic Obstructive Pulmonary Disease Patients with Respiratory Failure

目的:探讨无创机械通气对慢性阻塞性肺疾病并发呼吸衰竭患者治疗的有效性。方法:将80例慢性阻塞性肺疾病并发呼吸衰竭患者随机分为治疗组和对照组,各40例。治疗组采用传统抗感染、平喘、化痰等治疗基础上加用无创机械通气治疗,而对照组则采用传统治疗,比较两组患者治疗后的症状改善情况、气管插管率,第3、6、12、24小时的呼吸频率(RR)、心率(HR)、血气分析的pH、PaO2、PaCO2指标变化及住院时间,评价治疗效果。结果:治疗组总有效率95.0%明显优于对照组72.5%,治疗组气管插管率12.5%明显低于对照组的10.0%,两组数据比较,具有统计学意义(P<0.05),治疗组治疗后第3、6小时的HR、RR、pH、PaO2、PaCO2平均值较治疗前明显改善(P<0.05),而对照组以上各指标改善不明显(P>0.05),第12、24小时的以上各项指标两组患者均明显改善,且治疗组改善状况更明显(P<0.05)。治疗组患者住院时间平均为(13.27±2.31)d明显短于对照组(21.14±4.26)d。故治疗组临床疗效明显优于对照组。结论:应用无创机械通气治疗慢性阻塞性肺疾病并发呼吸衰竭,可显著改善患者临床症状,减少气管插管率,较快纠正酸中毒、减少住院时间,疗效肯定。

Research on the efficacy of Noninvasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease patients with respiratory failure. Methods：Divide 80 cases of chronic obstructive pulmonary disease patients with respiratory failure randomly into treatment group and control group each with 40 cases. The patients in treatment group were treated with Noninvasive mechanical ventilation based on using the traditional anti-infec- tion, asthma, phlegm and other treatment,while others in control group were treated with traditional treatment. Compare these 2 groups＇ improvement of symptoms, rate of endotracheal intubation respiratory rate （RR）, the heart rate （HR）, blood gas analysis of pH, PaO2, PaCOz indicators in 34, 6^th, 19^th and 24^th hour and hospitalization after treatment. Evaluate the therapeutic effect. Results：The total effective rate of treatment group was 95%, significantly better than the control group, 72. 5%. Treatment group intubation rate is 1%, significantly lower than the control group, 10%. These two sets of data were statistically significant（P〈0. 05）. The treatment group＇s HR, RR, pH, PaO2, PaCO2 average values in 3^rd, 6^th hour significantly improved after treatment（P〈0. 05）, while the control group＇s show no obvious improvement（P〈0. 05）. These values in 12^th, 24^th hour both improved significantly, and the treatment group was more obvious（P〈0. 05）. The treatment group＇s average length of stay was （13. 27±2. 31）days, significant- ly shorter than the control group （21.14±4. 26）days. Clinical efficacy of the treatment group was significantly better than the control group. Conclusion. Using Noninvasive mechanical ventilation in curing chronic obstructive pulmonary disease patients with respiratory failure can significantly improve the clinical symptoms and reduce the rate of endotracheal intubation, correct acidosis quickly, and reduce hospitalization time. The efficacy is worthy of recognition.