简化临床肺部感染评分评估无创通气治疗AECOPD呼吸衰竭疗效的价值

Clinical value of simplified clinical pulmonary infection score in evaluating the efficacy of noninvasive ventilation therapy in the treatment of patients with AECOPD and respiratory failure

目的探讨简化临床肺部感染评分在评估无创通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭疗效中的应用价值。方法回顾性分析我院收治的60例AECOPD合并呼吸衰竭患者的临床资料,均接受无创正压通气(NIPPV)治疗,根据治疗效果分为有效组与无效组,根据简化临床肺部感染评分(CPIS)将患者分为>6分与≤6分两组,比较不同组患者的临床治疗有效率。结果所有60例患者经NIPPV治疗后有效者42例,有效组与无效组患者上机前的血气分析、呼吸、心率等指标比较差异均无统计学意义(P>0.05),但有效组的简化CPIS明显低于无效组,差异有统计学意义(P<0.05);简化CPIS≤6分者治疗有效率为80%,明显高于>6分者的50%,差异有统计学意义(P<0.05)。结论简化CPIS可作为NIPPV治疗AECOPD合并呼吸衰竭疗效的有效预测指标,简化CPIS≤6分提示NPPV疗效较好。

Objective To investigate the clinical value of simplified clinical pulmonary infection score （sC-PIS） in evaluating the efficacy of non-invasive positive pressure ventilation （NIPPV） in patients with AECOPD and re-spiratory failure. Methods The clinical data of 60 patients with AECOPD and respiratory failure treated by NIPPV were retrospectively analyzed, which were divided into an effective group and ineffective group according to efficacy and sCPIS〉6 group and sCPIS≤6 group based on sCPIS. The clinical efficiency was compared between different groups. Results Of the 60 patients, 42 patients were found effective to NIPPV. There were no significant difference in effective group and ineffective group in blood gas analysis, breathing, heart rate and other indicators before NIPPV （P〉0.05）, but the sCPIS was significantly lower in effective group than ineffective group （P〈0.05）. The therapeutically effective rate was 80%in patients with sCPIS≤6, and it was significantly higher than patients with sCPIS〉6 （P〈0.05）. Conclusion The sCPIS is an effective predictor of NIPPV treatment in AECOPD combined respiratory fail-ure, and sCPIS≤6 indicates a good effect for NPPV.