无创通气联合体外膈肌起搏治疗慢性阻塞性肺疾病急性加重患者临床效果观察

Clinical Observation of Non-invasive Ventilation Combined with Extracorporeal Diaphragm Pacing in the Treatment of Patients with Acute Exacerbation of COPD

目的探究无创通气联合体外膈肌起搏治疗慢性阻塞性肺疾病急性加重患者临床的治疗效果。方法选取2018年1月-12月新乡市第一人民医院收治的60例慢性阻塞性肺疾病急性加重患者作为研究对象,随机将60例患者分作对照组与观察组,各取30例。对照组给予体外膈肌起搏治疗,观察组给予体外膈肌起搏联合无创通气治疗,连续治疗7d后,比较两组临床效果。结果治疗后,两组呼吸频率、心率均低于治疗前(P<0.05);观察组呼吸频率、心率均低于对照组(P<0.05);两组血氧分压(PaO2)均有所增加,而两组二氧化碳分压(PaCO2)均有所降低,治疗前后比较有显著差异(P<0.05);观察组PaO2高于对照组,PaCO2低于对照组,两组比较差异显著(P<0.05);治疗后,两组第一秒呼出气量(FEV1)、第一秒呼出气量/用力肺活量(FEV1/FVC)均有所增加,治疗前后有显著差异(P<0.05);观察组FEV1、FEV1/FVC均高于对照组,两组比较差异显著(P<0.05)。结论慢性阻塞性肺疾病急性加重患者应用无创通气联合体外膈肌起搏治疗效果理想,而且可以有效改善患者的预后,具有重要应用价值,可以应用于临床。

Objective To explore the clinical effect of non-invasive ventilation combined with extracorporeal diaphragm pacing on patients with acute exacerbation of COPD.Methods 60 patients with acute exacerbation of COPD admitted tothe First People's Hospital of Xinxiang from January to December 2018 were selected as the study subjects and were randomly divided into the control group and the observation group,30 patients in each group.The control group was treated with extracorporeal diaphragmatic pacing,while the observation group was treated with extracorporeal diaphragmatic pacing combined with noninvasive ventilation.After continuous treatment for 7 days,the clinical therapeutic effects of the two groups were compared.Results After treatment,respiratory rate and heart rate in both groups were lower than that before treatment(P<0.05).Respiratory rate and heart rate in the observation group were lower than those in the control group(P<0.05).Partial blood oxygen pressure(PaO2)increased in both groups,while partial carbon dioxide pressure(PaCO2)decreased in both groups,and there were significant difference before and after treatment(P<0.05).PaO2 in the observation group was higher than that in the control group,while PaCO2 was lower than that in the control group.The difference between the two groups was significant(P<0.05).After treatment,FEV1 and FEV1/FVC were increased in both groups,with significant difference before and after treatment(P<0.05).Both FEV1 and FEV1/FVC in the observation group were higher than those in the control group,with significant differences between the two groups(P<0.05).Conclusion Non-invasive ventilation combined with extracorporeal diaphragmatic pacing in patients with acute exacerbation of COPD has an ideal therapeutic effect,and can effectively improve the prognosis of patients,which has important application value and can be applied in clinical practice.