有创-无创序贯通气治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的临床效

Clinical effect of invasive and non-invasive sequential ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease with respiratory failure

目的:探讨有创-无创序贯通气治疗慢性阻塞性肺疾病急性加重(AECOPD)合并严重呼吸衰竭患者的临床效果。方法:筛选2016年1月—2016年12月到我院来就诊的100例AECOPD合并严重呼吸衰竭患者,随机分为两组,各50例。对照组患者采取单纯有创通气治疗,观察组患者采用有创-无创序贯通气治疗,观察、记录和对比两组患者的治疗效果,回顾性分析两组患者的临床资料。分别记录两组患者治疗前后机体的通气状态,包括动脉氧分压(PaO_2)、24小时动脉血氧饱和度(SaO_2)、pH值、动脉血二氧化碳分压(PaCO_2)等指标的变化情况及不良事件的发生概率。结果:两组患者治疗前的SaO_2、PaCO_2、PaO_2和pH等基本特征都无显著性差异,P>0.05,无统计学意义;治疗后,两组患者的SaO_2、PaCO_2、PaO_2和pH等指标的变化都非常显著,P<0.05,具有统计学意义,但两组患者之间无显著性差异,不具有统计学意义(P>0.05)。然而,统计分析结果显示,观察组患者的不良反应发生率(14.00%)明显低于对照组患者(50.00%),P<0.05,具有统计学意义。结论:有创-无创序贯通气治疗AECOPD合并严重呼吸衰竭患者的临床效果非常显著,而且能够明显降低患者的不良事件发生率。

Objective： To explore the clinical effect of invasive and non-invasive sequential ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） with respiratory failure. Method： 100 cases of AECOPD patients with severe respiratory failure treated in our hospital from January 2016 to December 2016 were screened, and were randomly divided into two groups, with 50 cases in each group. Patients in the control group were treated with invasive ventilation alone; patients in the observation group were treated with invasive and non-invasive sequential ventilation; the therapeutic effects of the two groups were observed, recorded and compared; and the clinical data of the two groups were analyzed retrospectively. Before and after treatment, ventilation status of patients in the two groups were recorded, including changes of arterial oxygen partial pressure （PaO2）, 24-hour arterial oxygen saturation （SaO2）, pH value, arterial carbon dioxide partial pressure （PaCO2） and other indicators, as well as occurrence probability of adverse events. Results： Before treatment, there was no significant difference in SaO2, PaCO2, PaO2 and pH between the two groups, and P〉0.05, the difference was not statistically significant. After treatment, SaO2, PaCO2, PaO2, pH and other indicators in the two groups were significantly changed, P〈0.05, the difference was statistically significant, but there was no significant difference between the two groups and the difference was of no statistical significance （P〉0.05）. However, the statistical analysis results showed that the adverse reaction rate of the patients in the observation group （14.00%） was significantly lower than that of the patients in the control group （50.00%）, and P〈0.05, the difference was statistically significant. Conclusion： Invasive and non-invasive sequential ventilation had significant clinical effect in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） with respiratory failure and it could significantly reduce the incidence of adverse events in patients.