双水平气道正压通气联合布地奈德福莫特罗对慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者的疗效分析

Research on the efficiency of bi-level positive airway pressure ventilation combined with Budesonide/Formoterol in the treatment of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

目的观察双水平气道正压通气(BiPAP)联合布地奈德福莫特罗对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者肺康复作用的临床研究。方法将150例AECOPD合并Ⅱ型呼吸衰竭患者,按照完全随机原则,分为观察组和对照组各75例。对照组给予氧疗、抗感染、布地奈德福莫特罗等治疗;观察组在常规治疗基础之上,给予Bi PAP辅助通气治疗。连续治疗7 d。结果 2组治疗7 d后,观察组总有效率(84.0%)优于对照组(70.6%),差异有统计学意义(P<0.05)。2组治疗7 d后,FEV1、PEF、pH、PaCO_2、PaO_2和CAT评分均较治疗前改善,但观察组改善优于对照组,差异有统计学意义(P<0.05)。观察组住院日和住院费用少于对照组,差异有统计学意义(P<0.05)。结论 Bi PAP联合布地奈德福莫特罗治疗AECOPD合并Ⅱ型呼吸衰竭疗效肯定,缓解临床症状,改善呼吸衰竭,提高生活质量和运动耐力,减少住院日和住院总费用,对肺康复具有较好作用。

Objective To investigate the clinical efficiency of bi-level positive airway pressure ventilation（ Bi PAP） combined with Budesonide/Formoterol in the treatment of chronic obstructive pulmonary disease（ COPD） complicated with type Ⅱ respiratory failure.Methods 150 AECOPD patients with type Ⅱ respiratory failure were randomly divided into observation group and control group,with 75 cases in each group.The control group was given oxygen therapy,anti-inflammatory,smooth wheezing and so on; based on regular treatment,the observation group was given 7 days＇ continuous Bi PAP treatment.Results After seven days treatment in both groups,the total effective rate of observation group（ 84.0%） was significantly higher than the control group（ 70.6%）,and the difference was statistically significant（ P〈0.05）.After seven days treatment in both groups,FEV1,PEF,pH,PaCO2,PaO2 and score of CAT were improved,but the observation group improved more than that of control group,and the differences were statistically significant（ P〈0.05）.The differences on hospitalization days and hospitalization expenses of the observation group was significantly less than the control group,and the differences were statistically significant（ P〈0.05）.Conclusion The efficiency of Bi PAP combined with Budesonide/Formoterol is a must on AECOPD with type Ⅱrespiratory failure,which can relieve clinical symptoms,improve the respiratory failure,improve the quality of life and exercise endurance,reduce the length of stay and the total cost of hospitalization,and has a good effect for the pulmonary rehabilitation.