氨茶碱联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者的临床疗效分析

Analysis of clinical effect by aminophylline combined with non-invasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease complicated with respiratory failure

目的分析无创正压通气联合氨茶碱治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的疗效。方法 88例慢性阻塞性肺疾病合并呼吸衰竭患者,运用计算机随机分组的方式分为对照组和观察组,各44例,对照组患者给予无创正压通气治疗,观察组患者则给予无创正压通气联合氨茶碱治疗,比较两组患者临床疗效和不良反应发生情况。结果治疗前,两组患者各肺功能指标(第一秒用力呼气容积占用力肺活量百分比、残气量/肺总量比值和肺一氧化碳弥散量)和动脉血气结果 (p H、动脉血气血氧分压、二氧化碳分压和血氧饱和度)差异无统计学意义(P>0.05),治疗后,观察组患者残气量/肺总量比值和肺一氧化碳弥散量和动脉血气结果明显优于对照组患者,差异有统计学意义(P<0.05),而两组患者第一秒用力呼气容积占用力肺活量百分比差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论无创正压通气联合氨茶碱治疗慢性阻塞性肺疾病合并呼吸衰竭临床疗效肯定,优于单用无创正压通气,具有安全高效和不良反应少等特点,值得在临床上进一步推广应用。

Objective To analyze the curative effect by aminophylline combined with non-invasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease （COPD） complicated with respiratory failure. Methods A total of 88 patients of chronic obstructive pulmonary disease complicated with respiratory failure were divided by computer randomization into control group and observation group, with 44 cases in each group. The control group received non-invasive positive pressure ventilation, and the observation group received aminophylline combined with non-invasive positive pressure ventilation. Clinical effects and adverse drug reactions of the two groups were compared. Results Before treatment, the differences of pulmonary function indications （proportion of forced expiratory volume in one second in forced vital capacity, residual volume/total lung capacity, and carbon monoxide diffusion capacity） and arterial blood gas results （pH, artery blood oxygen partial pressure, partial pressure of carbon dioxide, and oxyhemoglobin saturation） between the two groups had no statistical significance （P〉O.05）. After treatment, the observation group had much better residual volume/ total lung capacity, carbon monoxide diffusion capacity, and arterial blood gas results than the control group. Their difference had statistical significance （P〈0.05）, while the difference of proportion of forced expiratory volume in one second in forced vital capacity was not statistically significant between the two groups （P〉0.05）. The difference of incidence of adverse reactions between the two groups had no statistical significance （P〉0.05）. Conclusion Combination of non-invasive positive pressure ventilation and aminophylline can provide precise effect in treating chronic obstructive pulmonary disease complicated with respiratory failure, and it is better than non-invasive positive pressure ventilation single treatment. This method has the advantages of safe and efficient with few adverse reactions, and it is worthy of further clinical promotion and application.