无创通气联合不同时机雾化吸入治疗AECOPD合并Ⅱ型呼吸衰竭患者的疗效对比

Comparison of therapeutic effects of noninvasive ventilation combined with different timing of atomizing inhalation in treatment of patients with AECOPD complicating type Ⅱ respiratory failure

目的比较无创通气联合不同时机给予氧气雾化吸入治疗慢性阻塞性肺疾病急性加重期（AECOPD）合并Ⅱ型呼吸衰竭的疗效。方法将2015年1～12月重庆医科大学附属第二医院呼吸科收治的60例AECOPD合并Ⅱ型呼吸衰竭患者随机分为观察组和对照组,每组30例。观察组在无创通气治疗同时给予氧气雾化吸入,对照组于无创通气治疗间歇期给予氧气雾化吸入。观察两组患者临床疗效和相关指标改善情况。结果观察组总有效率[93.3%（28/30）]、p H值（7.40±0.06）、动脉血氧分压[（82.93±12.36）mm Hg]、动脉血二氧化碳分压[（62.00±6.92）mm Hg]、心率[（92.50±5.40）次/分]、呼吸频率[（16.00±3.00）次/分]、用力1秒呼气量[（3.20±0.50）V/L]及6分钟步行试验[（260.00±30.00）m]明显优于对照组[分别为56.7%（17/30）,7.38±0.14,（79.75±12.76）、（65.03±8.90）mm Hg,（95.60±7.70）、（20.00±4.00）次/分,（2.90±0.50）V/L,（240.00±25.00）m],差异均有统计学意义（P〈0.05）。结论无创通气同时联合雾化吸入药液治疗AECOPD合并Ⅱ型呼吸衰竭具有显著疗效。

Objective To compare the effects of noninvasive ventilation combined with different timing for giving the oxygen atomizing inhalation in the treatment of the patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） complicating type II respiratory failure. Methods Totally 60 patients with AECOPD complicating type Ⅱ respiratory failure admitted to the respiration department of the Second Affiliated Hospital of Chongqing Medical University from January to December 2015 were randomly divided into the observation group and control group,30 cases in each group. The observation group was given the oxygen atomizing inhalation combined with noninvasive ventilation at the same time,while the control group was given oxygen atomizing inhalation in the interval of noninvasive ventilation. The clinical efficacy and improvement of relevant indicators were observed in two groups. Results The total effective rate,p H value,arterial oxygen partial pressure,arterial carbon dioxide partial pressure,heart rate,respiratory rate,forced expiratory volume in one second（FEV1） and 6 min walking test in the observation group were 93.3%（28/30）,7.40 ±0.06,（82.93 ±12.36）mm Hg,（62.00 ±6.92）mm Hg,（92.50 ±5.40）beats/min,（16.00±3.00）times/min,（3.20±0.50）V/L and（260.00±30.00）m,which were significantly better than 56.7%（17/30）,7.38±0.14,（79.75±12.76）mm Hg,（65.03±8.90）mm Hg,（95.60±7.70）beats/min,（20.00±4.00）times/min,（2.90±0.50）V/L and（240.00±25.00）min the control group,the differences were statistically significant（P〈0.05）. Conclusion Noninvasive ventilation combine with drug atomizing inhalation has a significant effect for treating AECOPD complicating type Ⅱ respiratory failure.