无创机械通气在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者中的应用效果

Application effect of noninvasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure patients

目的探讨无创机械通气在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者中的应用效果。方法选取徐州市贾汪区人民医院2014年12月—2016年12月收治的COPD合并Ⅱ型呼吸衰竭患者50例,随机分为对照组和试验组,每组25例。对照组患者给予内科治疗,试验组患者在对照组基础上加施无创机械通气治疗,均持续治疗3个月。比较两组患者治疗前后呼吸频率(RR)、氢离子活动指数(PH)、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(Pa CO2)、血氧饱和度(SpO_2)及6 min步行距离(6MWD),并观察患者不良反应发生情况。结果治疗前,两组患者RR、PH、PaO_2、Pa CO2、SpO_2及6MWD比较,差异无统计学意义(P>0.05);治疗后,试验组患者RR、Pa CO2低于对照组,PH、PaO_2、SpO_2高于对照组,6MWD长于对照组(P<0.05)。试验组患者不良反应发生率高于对照组(P<0.05)。结论无创机械通气在COPD合并Ⅱ型呼吸衰竭患者中的应用效果确切,可明显纠正患者血气分析指标,有效改善患者的RR,但在治疗期间应注意不良反应发生情况。

Objective To investigate the clinical efficacy of noninvasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease（ COPD） complicated with type Ⅱ respiratory failure patients. Methods A total of 50 cases of COPD complicated with type Ⅱ respiratory failure patients were selected from December 2014 to December 2016 in Jiawang District People＇s Hospital of Xuzhou,which were randomly divided into control group and experimental group,25 cases in each group. Control group was treated with medical therapy,experimental group was given noninvasive mechanical ventilation based on control group,continuous treatment for 3 months. The RR,PH,PaO2,Pa CO2,SpO2 and 6MWD were compared before and after treatment between the two groups,and the incidence rate of adverse reactions were observed. Results Before treatment,no statistical significant differences of RR,PH,PaO2,Pa CO2,SpO2 or 6MWD was found between the two groups（ P〉0. 05）; after treatment,the experimental group of RR,Pa CO2 were lower than control group,PH,PaO2,SpO2 were higher than control group,6MWD was longer than control group（ P〈0. 05）. The incidence rate of adverse reactions of experimental group was higher than control group（ P〈0. 05）. Conclusion Noninvasive mechanical ventilation has an obviously clinical effect in the treatment of COPD complicated with type II respiratory failure patients,it can obviously improve blood gas analysis of patients,effectively improve the RR,but need to be paid attention to the occurrence of adverse reactions during the treatment.