无创通气联合全身糖皮质激素在AECOPD院前急救的应用价值

Application Value of Noninvasive Ventilation Combined with Systemic Glucocorticoids in Pre-hospital Care of AECOPD

目的探讨无创机械通气联合全身糖皮质激素在AECOPD院前急救的应用价值。方法选取2014年1月—2017年12月该院接诊的120例AECOPD患者,根据治疗方案分为两组,观察组在常规对症治疗基础上,给予全身糖皮质激素以及无创机械通气治疗。对照组在常规治疗基础上联合全身糖皮质激素治疗。分析两组患者治疗前、治疗后呼吸频率、心率、脉氧饱和度的变化。结果观察组治疗后呼吸频率(20.5±5.5)次/min较治疗前(32.4±4.6)次/min明显下降,差异有统计学意义(t=11.009,P<0.05),脉氧饱和度(92.4±3.8)%较治疗前(81.4±8.9)%明显上升,差异有统计学意义(t=7.570,P <0.05)。对照组患者治疗后的呼吸频率较治疗前改变差异无统计学意义(P>0.05),脉氧饱和度较治疗前改变差异无统计学意义(P>0.05)。两组患者治疗前与治疗后的心率改变差异无统计学意义(P>0.05)。结论无创通气联合全身糖皮质激素是AECOPD院前急救的有效手段。

Objective To investigate the value of non-invasive mechanical ventilation combined with systemic glucocorticoids in pre-hospital care of AECOPD.Methods A total of 120 patients with AECOPD who were admitted from January 2014 to December 2017 were enrolled.The patients were divided into two groups according to the treatment plan.The observation group was given systemic glucocorticoids and non-invasive mechanical ventilation on the basis of conventional symptomatic treatment.The control group was treated with systemic glucocorticoids on a routine basis.The changes of respiratory rate,heart rate and pulse oxygen saturation before and after treatment were analyzed.Results The respiratory rate(20.5±5.5)times/min in the observation group was significantly lower than that before treatment(32.4±4.6)times/min.The difference was statistically significant(t=11.009,P<0.05),and the pulse oxygen saturation(92.4±3.8)%was better than before treatment(81.4±8.9)%,increased significantly,the difference was statistically significant(t=7.570,P<0.05).The respiratory rate of the control group was not significantly different from that before treatment(P>0.05),and the pulse oxygen saturation was not significantly changed before treatment(P>0.05).There was no significant change in heart rate between the two groups before and after treatment(P>0.05).Conclusion Noninvasive ventilation combined with systemic glucocorticoids is an effective means of pre-hospital AECOPD.