无创呼吸机治疗COPD合并Ⅱ型呼吸衰竭的临床效果及安全性观察

Clinical effect and safety of noninvasive ventilator in treating COPD with typeⅡ respiratory failure

目的探讨无创呼吸机用于COPD合并Ⅱ型呼吸衰竭的效果。方法选取2016年5月~2017年10月期间本院收治的COPD伴Ⅱ型呼吸衰竭患者300例为研究对象,随机分为观察组和对照组,各150例。对照组给予常规药物治疗,观察组在对照组的治疗基础上使用无创呼吸机,比较两组患者的和血气指标和疗效。结果观察组和对照组患者治疗前p H、SPO2和Sj VO2比较差异无统计学意义,观察组治疗后的SPO2、Sj VO2明显改善,优于对照组,差异具有统计学意义(P<0.05)。治疗后观察组患者的EF(48.52±3.86)%、CI(2.47±0.48)min/m2、LVEDd(51.11±2.16)mm、LVEDs(38.63±2.74)mm心功能指标显著优于对照组,两组比较差异具有统计学意义(P<0.05)。结论应用无创呼吸机对COPD合并Ⅱ型呼吸衰竭患者有显著疗效,可改善患者心功能,减少患者插管率,缩短住院时间,安全可靠,值得进一步推广。

Objective To investigate the effect of noninvasive ventilator on COPD with typeⅡrespiratory failure. Methods 300 patients with COPD and typeⅡrespiratory failure treated in our hospital from May 2016 to October 2017 were selected as the research object, randomly divided into observation group and control group, with 150 cases in each group. The control group was given conventional drug treatment and observation group based on the treatment of non-invasive ventilation in the control group, compared with two groups of patients and blood gas indicators and efficacy. Results There were no significant differences in p H, SPO2 and Sj VO2 between the observation group and the control group before treatment.SPO2 and Sj VO2 in the observation group were significantly improved, which were better than those in the control group（P〈0.05）. After treatment,the cardiac function indexes of EF（48.52±3.86）%, CI（2.47±0.48） min/m2, LVEDd（51.11±2.16） mm and LVEDs（38.63±2.74） mm were significantly higher in the observation group than in the control group. The difference was statistically significant（P〈0.05）. Conclusion The application of noninvasive ventilator has a significant effect on COPD patients with type Ⅱ respiratory failure, which can improve the cardiac function, reduce the intubation rate and shorten the hospitalization time. Safe and reliable, it is worth further promotion.