不同体位下无创通气对COPD合并Ⅱ型呼吸衰竭患者通气效果的影响

Effect of Different Positions under Noninvasive Ventilation on Ventilation Effect of Chronic Obstructive Pulmonary Disease Combined with TypeⅡRespiratory Failure

目的:探讨不同体位下无创通气对慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者通气效果的影响。方法:选取2015年8月-2019年6月本院收治的COPD合并Ⅱ型呼吸衰竭患者96例,均行无创通气治疗。采用随机数字表法将其分为对照组和观察组,每组48例。对照组采用平卧位,观察组采用坐位。比较两组患者的通气效果。结果:无创通气后,两组FEV1、FEV1/FVC、MVV、潮气量、血氧饱和度均高于无创通气前,且观察组上述指标均高于对照组,差异均有统计学意义(P<0.05)。无创通气后,两组呼吸频率、心率、吸气压力均低于无创通气前,且观察组上述指标均低于对照组,差异均有统计学意义(P<0.05)。观察组气喘缓解时间、有效排痰时间均短于对照组,差异均有统计学意义(P<0.05)。结论:COPD合并Ⅱ型呼吸衰竭患者行无创通气时,坐位的通气效果更佳,值得临床推广使用。

Objective:To explore the effect of different positions under noninvasive ventilation on the ventilation effect of chronic obstructive pulmonary disease(COPD)combined with typeⅡrespiratory failure.Method:A total of 96 COPD with typeⅡrespiratory failure patients admitted to our hospital from August 2015 to June 2019 were selected,all patients were treated with noninvasive ventilation.They were divided into the control group and the observation group by random number table method,with 48 cases in each group.The control group was supine and the observation group was seated.The ventilation effects of two groups were compared.Result:After noninvasive ventilation,FEV1,FEV1/FVC,MVV,tidal volume and blood oxygen saturation in two groups were all higher than those of before noninvasive ventilation,and the above indexes in the observation group were all higher than those in the control group,there were statistically significant differences(P<0.05).After noninvasive ventilation,respiratory rate,heart rate and inspiratory pressure in two groups were lower than those of before noninvasive ventilation,and the above indexes in the observation group were lower than those in the control group,there were statistically significant differences(P<0.05).The duration of asthma relief and effective sputum excretion in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:COPD combined with typeⅡrespiratory failure patients treated with noninvasive ventilation,the ventilation effect of sitting position is better,which is worthy of clinical application.