普米克令舒/可必特辅助BiPAP治疗老年AECOPDⅡ型呼吸衰竭的效果评价

Evaluation of Pulmicort/Combivent Combined with BiPAP in the Treatment of Elderly Patients with AECOPD Type Ⅱ Respiratory Failure

目的:观察普米克令舒/可必特辅助BiPAP呼吸机治疗老年AECOPDⅡ型呼吸衰竭的临床效果。方法:选择2014年9月-2016年4月在本院治疗的老年AECOPDⅡ型呼吸衰竭患者66例,按照随机、平行对照原则分为观察组和对照组,对照组给予在常规治疗基础上辅以BiPAP呼吸机辅助通气,观察组在对照组基础上联合普米克令舒/可必特雾化吸入,比较两组患者治疗效果。结果:观察组临床总有效率为90.91%,对照组为69.69%,差异有统计学意义(P<0.05);观察组FEV_1、FVC均明显高于对照组,改良呼吸困难指数评分(mMRC)低于对照组,差异均有统计学意义(P<0.05);在动脉血气方面,观察组SaO_2、PaO_2、pH值均显著高于对照组,PaCO_2低于对照组,差异均有统计学意义(P<0.05);观察组呼吸机支持时间、住院天数均明显少于对照组(P<0.05);在不良反应发生率方面,观察组明显低于对照组(9.09%vs 27.27%),差异有统计学意义(P<0.05)。结论:在常规治疗基础上应用BiPAP呼吸机联合普米克令舒/可必特雾化吸入能够显著提高老年AECOPDⅡ型呼吸衰竭患者的临床疗效,改善通气功能,值得临床大力推广。

Objective： To observe the clinical effect of Pulmicort/Combivent supplementation with BiPAP ventilator in the treatment of elderly patients with AECOPD type Ⅱ respiratory failure.Method： Forty-eight patients with AECOPD type Ⅱ respiratory failure were enrolled in this study from September 2014 to April 2016.They were divided into the observation group and the control group according to the principle of random and parallel control. The control group was given BiPAP ventilator on the basis of routine therapy assisted ventilation, the observation group on the based of the control group was given Pulmicort/Combivent atomized inhalation, the therapeutic effects of two groups were compared.Result： The clinical effective rate in the observation group was 90.91%, the control group was 69.69%, the difference was statistically significant （P〈0.05） .FEVI and FVC in the observation group were significantly higher than those in the control group, the improved dyspnea score （ mMRC ） was lower than that of the control group （ P〈0.05 ） .The arterial blood gas, the levels of SaO2, PaO2 and pH in the observation group were significantly higher than those of the control group （ P〈0.05 ）, and the differences were statistically significant （ P〈0.05 ） .The incidence of adverse reactions in the observation group was significantly lower than that in the control group （9.09% vs 27.27% ）, the difference was statistically significant （P〈0.05） .Conclusion： BiPAP ventilator combined with Pulmicort/Combivent can be used to improve the clinical efficacy of elderly patients with AECOPD and improve the ventilation function.It is worthy to be popularized in clinical practice.