无创通气治疗慢性阻塞性肺病合并呼吸衰竭的临床研究

Clinical Research on Noninvasive Ventilation in Treating Chronic Obstructive Pulmonary Disease Complicated by Respiratory Failure

目的探讨无创通气治疗慢性阻塞性肺病合并呼吸衰竭的临床效果。方法选择2011年2月至2013年4月昆山市第二人民医院收治的90例慢性阻塞性肺病合并呼吸衰竭患者为研究对象,依据随机数字表法分成两组:对照组45例予以祛痰、抗感染、解痉平喘等治疗,观察组45例在对照组的基础上给予无创通气治疗,比较两组治疗后的临床效果,观察两组在酸碱度(p H)、动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、动脉血气变化情况。结果两组患者治疗前p H、Pa O2、Pa CO2、心率和呼吸频率比较差异均无统计学意义(P>0.05);治疗后2 h和24 h的Pa O2和p H均呈上升趋势高,Pa CO2、心率、呼吸频率均呈下降趋势,差异均有统计学意义(均P<0.05),而观察组较对照组p H、Pa O2升高更显著,Pa CO2、心率和呼吸频率较对照组下降更显著(P<0.05)。观察组的好转率高于对照组,加重率低于对照组,住院时间短于对照组,差异均有统计学意义(均P<0.05)。结论无创通气治疗慢性阻塞性肺病合并呼吸衰竭临床效果满意。

Objective To investigate the clinical effect of non-invasive ventilation on chronic obstructive pulmonary disease（ COPD） complicated by respiratory failure. Methods A total of 90 patients with COPD complicated by respiratory failure admitted to Kunshan Second People＇s Hospital from Feb. 2011 to Apr. 2013 were selected as research objects,and randomly divided into two groups： patients in the control group（ 45cases） received expectorant,anti-infective,antispasmodic treatment,while patients in the observation group（ 45 cases） were given non-invasive ventilation therapy basing on the treatment of control group,the clinical situation and effects of the two groups were compared after treatment. Changes of p H（ p H）,arterial partial oxygen pressure（ Pa O2）,carbon dioxide partial pressure（ Pa CO2）,arterial blood gas of the two groups were observed. Results Before treatment,p H,Pa O2,Pa CO2,heart rate and respiratory rate of the two groups had no statistically significant differences（ P 0. 05）. But 2 h and 24 h after treatment,levels of Pa O2 and p H of the two groups were increased,Pa CO2 level,heart rate,respiratory frequency were decreased,the differences were statistically significant（ P 0. 05）. While levels of p H,Pa O2 of the observation group increased more significantly than the control group,Pa CO2 level,heart rate and respiratory rate of the observation group decreased more significantly than the control group（ P 0. 05）. Improvement rate of the observation group was higher than the control group,exacerbation rate was lower than the control group,hospitalization time was less than the control group,the differences were statistically significant（ P 0. 05）. Conclusion Clinical effect of non-invasive ventilation in treating chronic obstructive pulmonary disease complicated by respiratory failure is satisfactory.