肺康复联合无创呼吸机治疗AECOPD合并呼吸衰竭的效果观察

Observation on the effect of lung rehabilitation combined with non-invasive ventilator in the treatment of AECOPD with respiratory failure

目的探讨肺康复联合无创呼吸机治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭的效果。方法 120例AECOPD合并呼吸衰竭患者,随机分为联合治疗组(62例)和无创呼吸机治疗组(58例)。无创呼吸机治疗组患者采用无创呼吸机治疗,联合治疗组患者采用肺康复联合无创呼吸机治疗,比较两组患者治疗效果。结果两组男性、年龄、有吸烟史、入院前慢性阻塞性肺疾病全球创议(GOLD)分级、慢性阻塞性肺疾病(COPD)病程、圣乔治呼吸问卷(SGRQ)评分及Ⅱ型呼吸衰竭、吸入任何糖皮质激素、吸入长效抗胆碱能药(LAMA)、吸入长效β2受体激动剂(LABA)、家庭氧疗、家庭呼吸机治疗情况比较,差异无统计学意义(P>0.05)。联合治疗组患者无创呼吸机时间、平均住院时间分别为(3.3±2.1)、(7.1±1.8)d,均短于无创呼吸机治疗组的(5.4±4.1)、(9.3±2.5)d,差异有统计学意义(P<0.05);两组患者气管插管发生情况及48 h后pH、二氧化碳分压(PaCO2)、氧分压(PaO2)比较,差异无统计学意义(P>0.05)。结论肺康复联合无创呼吸机治疗AECOPD患者可显著缩短呼吸机使用时间、住院时间。

Objective To discuss the effect of lung rehabilitation combined with non-invasive ventilator in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with respiratory failure.Methods A total of 120 AECOPD patients with respiratory failure were randomly divided into combined treatment group(62 cases)and non-invasive ventilator group(58 cases).Non-invasive ventilator group was treated with non-invasive ventilator,and combined treatment group was treated with lung rehabilitation combined with non-invasive ventilator.The treatment effect in two groups was compared.Results Both groups had no statistically significant difference in male,age,smoking history,pre-admission global initiative for chronic obstructive lung disease(GOLD)grading,chronic obstructive pulmonary disease(COPD)course,St.George’s Respiratory Questionnaire(SGRQ)score,typeⅡrespiratory failure,inhalation of any glucocorticoids,inhalation of long-acting anticholinergics(LAMA),inhalation of long-actingβ2 receptor agonists(LABA),home oxygen therapy and home ventilator therapy(P>0.05).Combined treatment group had shorter non-invasive ventilator time and mean hospitalization time respectively as(3.3±2.1)and(7.1±1.8)d than(5.4±4.1)and(9.3±2.5)d in noninvasive ventilator group,and the difference was statistically significant(P<0.05).Both groups had no statistically significant difference in occurrence of tracheal intubation and pH,partial pressure of carbon dioxide(PaCO2)and partial pressure of oxygen(PaO2)at 48 h after intubation(P>0.05).Conclusion Lung rehabilitation combined with non-invasive ventilator can significantly shorten the duration of ventilator and hospitalization in patients with AECOPD.