无创呼吸机治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效探讨

The exploration of the clinical efficacy of noninvasive ventilator in the treatment of chronic obstructive pulmonary disease with respiratory failure

目的探讨无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床疗效。方法将本院2014年10月至2015年10月收治的68例COPD合并呼吸衰竭患者随机分为观察组及对照组,每组各34例。对照组患者行常规治疗,观察组患者在常规治疗基础上加用无创呼吸机治疗。观察并比较两组患者心率、呼吸频率、动脉血氧饱和度(Sa O_2)、动脉血二氧化碳分压(Pa CO_2)、动脉血氧分压(PaO_2)、血液p H、住院情况、气管插管率及不良反应发生情况,从而判断无创呼吸机的治疗效果。结果观察组患者心率、呼吸频率、血液p H改善情况较对照组更明显(P<0.05);Pa CO_2显著低于对照组(P<0.05);PaO_2、Sa O_2均显著高于对照组(P<0.05)。两组患者住院费用比较差异无显著性(P>0.05)。观察组患者平均住院时间明显短于对照组(P<0.05),再次入院次数显著少于对照组(P<0.05)。两组均未出现死亡病例。观察组患者仅1例需气管插管,气管插管率明显低于对照组(P<0.05)。对照组患者总不良反应发生率明显低于观察组(P<0.05)。结论 COPD合并呼吸衰竭患者应用无创呼吸机治疗的临床效果明显,值得临床推广应用。

Objective To evaluate the clinical efficacy of noninvasive ventilator in the treatment of chronic obstructive pulmonary disease（COPD） with respiratory failure. Method 68 COPD with respiratory failure patients treated in our hospital from October 2014 to October 2015 were randomly divided into observation group and control group（34 patients in each group）. Control group patients underwent conventional treatment, while observation group patients received noninvasive ventilator treatment on the basis of conventional therapy. Observed and compared heart rate, respiratory rate, Sa O2 Pa CO2, Pa O2 and p H, hospitalization data, tracheal intubation rate and the incidence of adverse reactions between the two groups, so as to determine the efficacy of noninvasive ventilator treatment. Result Compared to control group, the improvement on heart rate, respiratory rate and blood p H of observation group were more significantly（P〈0.05）; Pa CO2 of observation group was significantly lower than control group（P〈0.05）; the oxygen partial pressure, Pa O2 and Sa O2 of observation group were significantly higher than control group（P〈0.05）. The hospitalization expenses of the two groups showed no significant difference（P〉0.05）. Observation group patients had significantly shorter average hospitalization days and less readmitted frequency than control group（P〈0.05）. The total incidence of adverse reactions of control group were significantly lower than observation group（P〈0.05）. There were no deaths occurred in both groups. Conclusion COPD with respiratory failure patients receiving additional noninvasive ventilator therapy, can acquire obvious clinical effect and safety, worthy of wider application.