沙美特罗替卡松粉吸入剂联合无创呼吸机治疗COPD并发呼吸衰竭的临床效果分析

Clinical Effect of Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation Combined with Noninvasive Ventilator in Treatment of COPD Patients with Respiratory Failure

目的探讨沙美特罗替卡松粉吸入剂联合无创呼吸机治疗老年慢性阻塞性肺疾病(COPD)并发呼吸衰竭的临床效果。方法对2016年10月—2018年1月收治的118例老年COPD并发呼吸衰竭患者的临床资料做回顾性分析。根据治疗方式的不同分为观察组和对照组,每组59例。对照组给予无创呼吸机治疗,观察组在对照组基础上联合沙美特罗替卡松粉吸入剂治疗,比较两组临床疗效、不良反应发生情况,以及治疗前后的肺功能、血气指标、生命体征指标及症状和体征评分。结果观察组临床总有效率高于对照组(P<0.05)。治疗后,两组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC、呼气峰值流速、血氧饱和度、6 min步行距离、氧分压和p H值均高于治疗前,且观察组高于对照组(P<0.05)。治疗后,两组的二氧化碳分压、呼吸频率、心率以及症状和体征评分低于治疗前,且观察组低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论沙美特罗替卡松粉吸入剂联合无创呼吸机治疗老年COPD并发呼吸衰竭的临床效果显著,可有效地提高患者肺功能,改善动脉血气、生命体征、临床症状和体征,且安全可靠。

Objective To investigate clinical effect of Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation combined with noninvasive ventilator in treatment of elderly patients with chronic obstructive pulmonary disease （COPD） complicated by respiratory failure. Methods Clinical data of 118 elderly patients with COPD complicated by respiratory failure admitted during October 2016 and January 2018 was retrospectively analyzed, and the patients were divided into observation group and control group （ n =59 for each group） according to different treatment methods. Control group was treated with noninvasive ventilator, while observation group was treated with Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation on the basis of treatment for control group. Curative effect, incidence rate of adverse reactions, pulmonary function, blood gas index, vital signs indexes, symptoms and signs scores before and after treatment were compared between two groups. Results The total effective rate in observation group was significantly higher than that in control group （ P 〈0.05）. After treatment, values of forced expiratory volume （FVC）, forced expiratory volume in one second （FEV1）, FEV1/FVC, peak flow velocity, blood oxygen saturation, 6 min walking distance, oxygen partial pressure and pH value were significantly higher than those before treatment in two groups, and the values in observation group were significantly higher than those in control group （ P 〈0.05）. After treatment, values of carbon dioxide pressure, respiratory rate, heart rate and symptoms and signs scores were significantly lower than those before treatment in two groups, and the values in observation group were significantly lower than those in control group （ P 〈0.05）. There was no significant difference in incidence rate of adverse reactions between two groups （ P 〉0.05）. Conclusion Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation combined with noninvasive ventilator in treatment of elderly patients with COPD complicated by respiratory failure is effective, and it may effectively improve pulmonary function, arterial blood gas, vital signs and clinical symptoms with good safety.