两种不同吸入方法治疗慢性阻塞性肺疾病合并呼吸衰竭效果的研究

Clinical study on treatment of two different aerosol inhalations for AECOPD complicated with respiratory failure

目的探讨两种不同吸入方法治疗慢阻肺合并呼吸衰竭的临床疗效。方法将66例慢阻肺疾病急性加重合并呼吸衰竭患者随机分为研究组和对照组,各33例。研究组采用无创正压通气同时联合雾化吸入布地奈德治疗;对照组采用中心管道氧气雾化吸入布地奈德治疗,采用SPSS 19软件分析。结果研究组与对照组入院时的情况基本相同(P>0.05);研究组治疗方法降低患者Pa CO_2效果较对照组更明显,差异有统计学意义(t=4.55 P=0.03);同样升高患者Pa O_2效果较对照组更明显,差异有统计学意义(t=4.70P=0.03);研究组治疗方法缓解患者呼吸困难效果较对照组更明显,差异有统计学意义(t=4.32 P=0.04);m MRC变化研究组治疗方法较对照组改善更明显,差异有统计学意义(t=2.55 P=0.01);CCQ变化研究组治疗方法较对照组改善更明显,差异有统计学意义(t=3.13 P=0.00)。结论无创正压通气同时联合雾化吸入布地奈德治疗方法与中心管道氧气雾化吸入布地奈德方法治疗慢阻肺急性加重期合并呼吸衰竭相比,可更有效的纠正缺氧、缓解患者呼吸困难,也可有效降低CO_2潴留。

Objective To explore the curative effect of two different aerosol inhalations for AECOPD patients complicated with respiratory failure .Methods 66 AECOPD patients complicated with respiratory failure were ran-domly divided into the study group and the control group （33 patients for each group）.For the study group, aerosol inhalation of budesonide treatment was simultaneously combined with noninvasive positive pressure ventilation .For the control group , noninvasive positive pressure ventilation was temporarily stopped during the aerosol inhalation of budesonide .All outcomes were statistically analyzed using SPSS 19 software package .Results There was no signifi-cant difference in basic situation between the two groups before treatment （ P〉0.05 ） .The decrease of PCO 2 after treatment was more obvious in the study group than in the control group （t=4.55, P=0.03）, and the increase of PO2 after treatment as more obvious in the study group than in the control group （t=4.70, P=0.03）.The remission of tachypnea in the study group was more significant than that in the control group （t=4.32, P=0.043）.The im-provement of mMRC in the study group was more significant than that in the control group （t=2.55, P=0.014）, and the improvement of CCQ in the study group was more significant than that in the control group （ t=3.13, P=0.003）.Conclusion While comparing with noninvasive positive pressure ventilation temporarily stopped , there are much more significant improvements and remissions of CO 2 retention, anoxia, tachypnea, dyspnea （mMRC）, quality of life （CCQ）, and other clinical indexes （clinical rating, APACHE II） by aerosol inhalation of budesonide com-bined with noninvasive positive pressure ventilation simultaneously .