无创通气联合舒利迭治疗老年慢性阻塞性肺疾病呼吸衰竭

Application and effects of noninvasive ventilation combined with seretide in the treatment of elderly patients with chronic obstructive pulmonary disease

目的：观察无创通气联合舒利迭在老年慢性阻塞性肺疾病呼吸衰竭患者中的应用及效果。方法以河南大学淮河医院2011年4月至2013年4月收治的92例老年慢性阻塞性肺疾病呼吸衰竭患者作为研究对象，分为两组。两组首先予以祛痰、抗感染、纠正酸碱与水电解质平衡、解痉平喘、营养支持等对症治疗。对照组行无创通气，观察组联合应用舒利迭。比较两组治疗前后肺功能指标及呼吸衰竭缓解情况。结果两组患者治疗前1s用力呼气量（FEV1）、FEV1%、FEV1/用力肺活量（FVC）的比较差异均未见统计学意义（P〉0.05）；治疗后，观察组各项肺功能指标均高于对照组，差异有统计学意义（P〈0.05）。第1天治疗结束后，观察组（97.9%）与对照组（100.0%）重度呼吸困难患者所占比例接近（P〉0.05），第2天（48.9% VS 71.1%）、第3天（19.1% VS 37.8%）观察组均低于对照组，差异有统计学意义（P〈0.05）。结论无创通气联合应用舒利迭治疗慢性阻塞性肺疾病呼吸衰竭，可迅速消除患者气道炎症反应，使其肺功能得到改善，呼吸衰竭症状缓解，效果满意，值得推广。

Objective To observe the application and effect of noninvasive ventilation combined with seretide in the treatment of elderly patients with chronic obstructive pulmonary disease. Methods Ninety-two COPD patients from A-pril 2011 to April 2013 were randomly divided into two groups. First of all, both groups were treated by regular definitive therapy, such as eliminating phlegm, anti-inflammation. Then the control group was treated by noninvasive ventilation and the observation group were treated by noninvasive ventilation combined with seretide. The changes of lung function index and remission of respiratory failure symptoms were detected. Results There was no significant difference in FEV1, FEV1%, FEV1/FVC between the two groups before therapy（P＆gt;0. 05）. After therapy, the lung function of observation group was significant higher than that of control group（P〈0. 05）. After the first day of therapy, there was no significant difference in the number of patients with severe breathing problem between observation group（97. 9%） and control group （100. 0%）（P＆gt;0. 05）. While, the number of the patient with severe breathing problem of observation group was signifi-cantly less than that of control group after the second（48. 9% VS 71. 1%） and third day（19. 1% VS 37. 8%） of therapy （P〈0. 05）. Conclusions Noninvasive ventilation combined with seretide can effectively improve the lung function and relieve the respiratory failure symptoms of COPD patients.