无创双水平正压通气治疗老年重症慢性阻塞性肺疾病急性加重期的临床疗效观察

Observation on clinical efficacy of noninvasive bi-level positive airway pressure in the treatment of severe acute exacerbation of chronic obstructive pulmonary disease in the elderly

目的探究对老年重症慢性阻塞性肺疾病(COPD)急性加重期患者应用无创双水平正压通气治疗的效果。方法 80例老年重症COPD急性加重期患者,按照治疗方法不同分为对照组和观察组,每组40例。对照组实施常规治疗,观察组在对照组基础上实施无创双水平正压通气治疗,观察比较两组患者治疗前后动脉血pH值、血氧分压(PaO_2)、血二氧化碳分压(PaCO_2)、吸入气中的氧浓度分数(FiO_2)、氧合指数(PaO_2/FiO_2)、心率等各指标水平。结果治疗前,两组患者各指标水平比较差异无统计学意义(P>0.05)。治疗后,对照组患者动脉血pH值、PaO_2、PaCO_2、FiO_2、PaO_2/FiO_2、心率各指标水平分别为(7.32±0.05)、(90.27±12.24)mmHg(1 mm Hg=0.133 kPa)、(28.36±10.95)mm Hg、(0.61±0.14)%、(231.25±36.54)、(106.5±10.8)次/min;观察组患者动脉血pH值、PaO_2、PaCO_2、FiO_2、PaO_2/FiO_2、心率各指标水平分别为(7.38±0.03)、(96.32±12.54)mmHg、(18.42±10.73)mmHg、(0.54±0.13)%、(287.95±40.28)、(91.5±20.1)次/min;治疗后两组各指标水平均优于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05)。结论无创双水平正压通气治疗老年重症COPD急性加重期的效果良好,因而具有临床推广价值。

Objective To investigate the effect of noninvasive bi-level positive airway pressure in the treatment of severe acute exacerbation of chronic obstructive pulmonary disease（COPD） in the elderly. Methods A total of 80 elderly patients with severe acute exacerbation of chronic obstructive pulmonary disease were divided by different treatment methods into control group and observation group, with 40 cases in each group. The control group received conventional therapy, and the observation group received noninvasive bi-level positive airway pressure on the basis of the control group. Observation and comparison were made on arterial blood pH, blood oxygen partial pressure（PaO2）, partial pressure of carbon dioxide（PaCO2）, oxygen concentration fraction（FiO2） in inhalation gas, oxygenation index（PaO2/FiO2）, heart rate before and after treatment between the two groups. Results Before treatment, both groups had no statistically significant difference in all indicators（P〉0.05）. After treatment, the control group had arterial blood pH, PaO2, PaCO2, FiO2, PaO2/FiO2 and heart rate respectively as（7.32±0.05）,（90.27±12.24） mmHg（1 mmHg=0.133 k Pa）,（28.36±10.95） mmHg,（0.61±0.14）%,（231.25±36.54） and（106.5±10.8） times/min, which were respectively（7.38±0.03）,（96.32±12.54） mm Hg,（18.42±10.73） mm Hg,（0.54±0.13）%,（287.95±40.28） and（91.5±20.1） times/min in the control group. After treatment, both groups had better indicators than before treatment, and the observation group was better than the control group. Their difference was statistically significant（P〈0.05）. Conclusion Noninvasive bi-level positive airway pressure shows good effect in treating severe acute exacerbation of COPD in the elderly, and it contains clinical promotion value.