无创正压通气治疗老年慢性阻塞性肺病患者的临床疗效及安全性分析

Clinical Efficacy and Safety Analysis of Noninvasive Positive Pressure Ventilation in Treatment of Elderly Patients with Chronic Obstructive Pulmonary Disease

目的探讨无创正压通气(NIPPV)治疗老年慢性阻塞性肺病(COPD)的临床疗效,研究分析其在治疗中的应用价值及安全性。方法选取老年慢性阻塞性肺病患者122例,随机分为观察组和对照组各61例。其中对照组给予常规治疗,观察组在常规治疗的基础上给予无创正压通气治疗,分别检测治疗前与治疗2个月后呼吸频率(RR)、心率(HR)、血压(BP)、动脉血气及肺通气功能情况,观察比较两组患者的临床疗效及安全性。结果观察组的总有效95.08%(58/61)显著高于对照组的73.77%(45/61),差异有显著性(χ2=10.536,P=0.001)。治疗2个月后,两组的p H、Pa O2较治疗前均显著升高,而Pa CO2较治疗前显著降低,肺功能指标均显著改善,RR、HR均显著降低,而BP无明显变化,且观察组的动脉血气参数、肺功能指标、RR、HR较对照组均明显改善。结论 NIPPV在治疗老年慢性阻塞性肺病中具有显著的临床疗效,且安全性高、并发症轻微,能够明显改善老年COPD患者的肺功能,缓解相关临床症状。

Objective To investigate the clinical efficacy of noninvasive positive pressure ventilation（ NIPPV） in treatment of elderly patients with chronic obstructive pulmonary disease（ COPD）,and research and analyze it’s application value and safety in the treatment. Method One hundred and twenty-two elderly patients with chronic obstructive pulmonary disease were selected,they were randomly divided into the control group and the observation group,61 cases in each group. The control group was given conventional therapy,the observation group was given noninvasive positive pressure ventilation on the basis of conventional therapy. Respiratory rate（ RR）,heart rate（ HR）,arterial blood gas and pulmonary ventilation function before treatment and after 2 months of treatment were detected,the clinical effect and security between the two groups were observed and compared. Result The total effective rate of observation group was 95. 08%（ 58 /61）,it was significantly higher than 73. 77%（ 45 /61） of control group（ χ2= 10. 536,P = 0. 001） 。After 2 months of treatment,p H,Pa O2 of the two groups compared with those before treatment were significantly increased,while Pa CO2 was significantly reduced,indexes of pulmonary function were significantly improved,RR,HR were significantly reduced（ P 〈 0. 05）,while BP had no significant changes（ P〉 0. 05）,and the arterial blood gas parameters,pulmonary function index,RR,HR in observation group were significantly improved compared with the control group（ P 〈 0. 05）. Conclusion Noninvasive positive pressure ventilation in treatment of elderly patients with chronic obstructive pulmonary disease has a good curative effect,with the advantage of high security and minor complications,can significantly improve the pulmonary function in elderly patients with COPD,relieve the related clinical symptoms,is one of the preferred clinical treatment,is worthy of clinical use.