无创正压通气联用呼吸兴奋剂治疗慢阻肺呼吸衰竭合并肺性脑病的效果观察

The effect observation on noninvasive positive pressure ventilation combined with respiratory stimulant in the treatment of chronic obstructive pulmonary respiratory failure combined with pulmonary encephalopathy

目的探讨无创正压通气联用呼吸兴奋剂治疗慢阻肺呼吸衰竭合并肺性脑病的临床效果。方法将104例慢阻肺呼吸衰竭合并肺性脑病患者随机分为观察组和对照组,各52例。对照组采用常规治疗,观察组在常规治疗基础上采用无创正压通气联用呼吸兴奋剂治疗。比较两组患者治疗前后的动脉二氧化碳分压(Pa CO2)、动脉氧分压(Pa O2)、动脉血氧饱和度(Sp O2)、酸碱度(p H)、心率(HR)和呼吸频率(RR);根据治疗转归情况,综合评价患者的疗效。结果治疗前后,观察组HR、RR、Pa O2、Sp O2、Pa CO2、p H的改善程度显著优于对照组(P<0.05)。观察组治疗有效率显著高于对照组,气管插管率、住院病死率均显著低于对照组,住院时间显著短于对照组,差异均有统计学意义(P<0.05)。结论无创正压通气联用呼吸兴奋剂治疗慢阻肺呼吸衰竭合并肺性脑病的效果确切,可显著恢复患者的呼吸功能,改善预后,促进病情愈合,降低气管插管率、住院病死率,具有临床可行性。

Objective To investigate the therapeutic effect of noninvasive positive pressure ventilation combined with respira-tory stimulant in the treatment of chronic obstructive pulmonary respiratory failure and pulmonary encephalopathy.Methods 104 patients with chronic obstructive pulmonary respiratory failure and pulmonary encephalopathy were randomly divided into the con-trol group and the observation group,52 cases in each group.The control group was treated with conventional therapy,the obser-vation group was treated with noninvasive positive pressure ventilation combined with respiratory stimulant therapy.Arterial oxy-gen partial pressure （PaO2 ）,arterial oxygen saturation （SpO2 ）,pH,heart rate （HR）,respiratory rate （RR）before and after treatment were compared between two groups.The therapeutic effect was evaluated according to treatment improvement condition. Results The improvement of HR,RR,PaO2 ,SpO2 ,PaCO2 and pH in the observation group were significantly higher than those in the control group before and after treatment （P〈0.05 ）.The effective rate in the observation group was significantly higher than that in the control group,with a lower mortality rate and shorter hospitalization time,and the differences were statisti-cally significant （P〈0.05）.Conclusion The effect of noninvasive positive pressure ventilation combined with respiratory stim-ulant in the treatment of chronic obstructive pulmonary disease with pulmonary encephalopathy is effective.It can improve the re-spiratory function and the prognosis of patients,promote the healing of the disease,reduce the rate of endotracheal intubation and mortality,and has clinical feasibility.