无创正压通气联合噻托溴铵吸入治疗慢性阻塞性肺疾病合并慢性呼吸衰竭的临床研究

Clinical study of NPPV combined with tiotropium inhalation for chronic obstructive pulmonary disease with chronic respiratory failure

目的:研究无创正压通气(NPPV)联合噻托溴铵吸入治疗慢性阻塞性肺疾病(慢阻肺)合并慢性呼吸衰竭(呼衰)的临床效果。方法:选取收治的慢阻肺合并慢性呼衰患者64例,随机将其分为对照组和研究组,各32例。对照组单纯予以NPPV治疗,在此基础上,研究组加用噻托溴铵吸入治疗。比较两组患者治疗情况及病死率,同时比较两组治疗前后的血气分析指标及肺功能指标水平。结果:治疗后,研究组住院时间、气管插管率及死亡率均显著优于对照组,差异有统计学意义(P<0.05);研究组PaO2、SaO2显著高于对照组,而PaCO2则低于对照组,差异有统计学意义(P<0.05);研究组FEV1、FEV1%、FVC均显著高于对照组,差异有统计学意义(P<0.05)。结论:NPPV联合噻托溴铵吸入治疗慢阻肺合并慢性呼衰具有较好的临床效果,可有效改善患者肺功能以及动脉血气,值得临床推荐。

Objective To investigate the clinical effects of non-invasive positive pressure ventilation(NPPV) combined with tiotropium inhalation for the treatment of chronic obstructive pulmonary disease(COPD) with chronic respiratory failure. Method Sixty-four patients with chronic obstructive pulmonary disease and chronic respiratory failure who were admitted to our hospital were randomly divided into control group and study group. 32 cases in each group. The control group was treated with NPPV alone. On this basis, the study group was treated with inhaled tiotropium. The treatment and mortality of the two groups were compared, and the blood gas analysis indexes and lung function index levels before and after the treatment were compared.Results After treatment, the hospitalization time, tracheal intubation rate and mortality rate of the study group were significantly better than the control group(P<0.05). PaO2 and SaO2 in the study group were significantly higher than in the control group, while PaCO2 was lower than in the control group(P<0.05). FEV1、FEV1%、FVC were significantly higher in the study group than in the control group(P<0.05).Conclusion The combination of NPPV and tiotropium bromide in the treatment of chronic obstructive pulmonary disease with chronic respiratory failure has good clinical effects, and can effectively improve the patient′s lung function and arterial blood gas, which is worthy of clinical recommendation.