ST模式和“TVV”模式在COPD慢性呼吸衰竭患者的疗效评价

Comparison of Curative Effect Between ST Mode and TVV Mode in Treatment of COPD Patients with Chronic Respiratory Failure

目的 比较ST模式和TVV模式(双重控制模式)在COPD慢性呼吸衰竭患者中的疗效。方法 回顾性分析2014年10月至2017年12月3年间本院83例COPD合并慢性呼吸衰竭患者的治疗效果,在治疗研究过程中有3例患者脱落,将纳入分析的80例患者按照随机数表法均分为研究组和对照组,入组研究组的患者采用TVV模式(双重控制模式)治疗,入组对照组的患者采用ST模式治疗。对比两组患者两组间和组内入院治疗前,入院治疗后24 h以及7 d的桡动脉血气分析中血氧分压(arterial partial pressure of oxygen,PaO_2)、二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_2)、实际碳酸氢盐(actual bicarbonate,AB)及动脉血pH值。对比研究组和对照组患者组内及组间治疗前与治疗后24 h的呼吸频率、心率。比较两组患者治疗后7 d发生不良反应的情况。结果 治疗后两组患者血气分析中的PaO_2、PaCO_2、动脉血AB及pH水平比较均无明显差异(P>0.05)。两组患者治疗后24h、7d血气分析的PaO_2和PaCO_2较治疗前有明显好转(P<0.05);治疗24h和7 d后两组患者的动脉血AB、pH水平与本组治疗前对比均无明显差异(P>0.05)。治疗后7d两组患者的呼吸频率和心率较治疗前明显降低(P<0.05)。治疗后7d研究组患者不良反应发生率明显低于对照组(P<0.05)。结论 TVV模式治疗呼吸衰竭的效果优于ST模式,患者不良反应发生较少,安全可靠。

Objective To compare the curative effect of TVV（Dual controlled ventilation） mode and ST（spontaneous breathing and time control） mode in the treatment of COPD patients with chronic respiratory failure.Methods The therapeutic effect on 83 COPD patients with chronic respiratory failure admitted into our hospital from October 2014 to December 2017 was retrospectively analyzed.3 patients having been excluded during the course of treatment, the rest 80 patients were randomly divided into study group and control group.The study group was treated with TVV mode, while the control group was given ST mode.The arterial partial pressure of oxygen（PaO_2）, arterial partial pressure of carbon（PaC02）, actual bicarbonate（AB）, and arterial blood pH in the radial artery blood gas analysis before treatment, 24 hours after treatment, and 7 days after treatment were compared within groups and between the two groups.The respiratory rate and heart rate before treatment and 24 hours after treatment, along with the incidence of adverse reactions 7 days after treatment, were also compared within groups and between the two groups.Results There was no significant difference in the PaCO_2, PaO_2, arterial blood pH and AB in the blood gas analysis after treatment between the two groups（P0.05）.Compared with those before treatment, the PaCO_2 and PaO_2 in the blood gas analysis 24 hours and 7 days after treatment were remarkably improved（P0.05）, but the arterial blood pH and AB were not（P0.05）.The respiratory rate and heart rate of the two groups were markedly lower after treatment than before treatment（P0.05）.The incidence of adverse reactions 7 days after treatment of the study group was obviously lower than that of the control group（P0.05）.Conclusion TVV mode proves better than ST mode in the treatment of respiratory failure, with more safety and reliablity and fewer adverse reactions.