纤维支气管镜联合无创正压通气治疗慢性阻塞性肺疾病并Ⅱ型呼吸衰竭的效果探讨

The Effect of Fiber Bronchoscopy Combined with Noninvasive Positive Pressure Ventilation on Chronic Obstructive Pulmonary Disease with Type Ⅱ Respiratory Failure

目的观察纤维支气管镜联合无创正压通气治疗慢性阻塞性肺疾病并Ⅱ型呼吸衰竭的效果。方法选取2013年1月—2016年7月在该院进行治疗的65例慢性阻塞性肺疾病并Ⅱ型呼吸衰竭患者,根据入院顺序分为实验组和对照组,其中实验组为33例,对照组为32例。两组患者都通过无创正压通气技术进行治疗,实验组患者加用纤维支气管镜进行治疗,对比两组患者的治疗效果。结果实验组患者治疗的总有效率为96.97%,对照组患者治疗的总有效率为78.12%,对比两组治疗有效率间的差异有统计学意义(P<0.05)。两组患者治疗后的PaCO_2水平均降低,而pH、PaO_2以及SaO_2水平均提高,对比治疗前后的差异有统计学意义(P<0.05)。实验组患者动脉血气指标的改善情况优于对照组,对比两组间差异有统计学意义(P<0.05)。结论纤维支气管镜联合无创正压通气治疗慢性阻塞性肺疾病并Ⅱ型呼吸衰竭的效果很好,提高了治疗效率,减少了无创正压通气时间、住院时间以及住院费用,并明显改善了患者动脉血气指标情况,在临床上值得进行推广应用。

Objective Observe fiber bronchoscope combined noninvasive positive pressure ventilation in patients with chronic obstructive pulmonary disease and the effect of the type II respiratory failure. Methods Select 2016-01 July 2013 in our hospital for treatment of 65 cases of patients with chronic obstructive pulmonary disease and type II respi- ratory failure, according to admission order is divided into the experimental group and control group, in which the ex- perimental group for 33 cases, control group of 32 cases. Two groups of patients were treated by noninvasive positive pressure ventilation technology, experimental group patients were treated with fiberoptic bronehoscopy, compare the treatment effect of two groups of patients. Results The experimental group were treated, the total effective rate of 96.97% in the control group were treated, the total effective rate was 78.12% contrast differences between the two groups of treatment effectiveness, with statistical significance （P〈0.05）. PaCO2 levels were lower after treatment in both groups, and pH, improving both the PaO2, SaO2, clear difference contrast before and after treatment, with statistical sig- nificance（P〈O.05）. The improvement of the experimental group patients with arterial blood gas index is superior to con- trol group, compare the obvious difference between the two groups, with statistical significance （P〈0.05）. Conclusion Fiberoptic bronehoscopy combined noninvasive positive pressure ventilation in patients with chronic obstructive pul-monary disease and type II respiratory failure effect is very good, to improve the treatment efficiency, reduce a nonin- vasive positive pressure ventilation time, length of hospital stay and hospital costs, arterial blood gas index, and signifi- cantly improve the patients in clinic is worth popularization and application.