无创比例辅助通气在慢性阻塞性肺疾病急性发作患者中的应用效果

Application effect of non-invasive proportional assisted ventilation in patients with acute attack of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)急性发作患者使用无创比例辅助通气(PAV)的效果及对患者氧代谢及肺功能的影响。方法采用随机数字表法将2016年3月至2018年3月长治医学院附属和济医院收治的93例COPD急性发作患者分为两组,PSV组(46例)行常规压力支持通气(PSV),PAV组(47例)行无创比例辅助通气,比较两组救治成功率、救治成功患者住院及呼吸机使用时间和治疗后氧代谢与肺功能情况。结果PAV组住院时间为(9.45±1.79)d,呼吸机使用时间为(4.49±0.26)d;PSV组住院时间为(13.12±1.68)d,呼吸机使用时间为(5.86±0.32)d,PAV组患者的住院时间及呼吸机使用时间短于PSV组患者,差异有统计学意义(P<0.05)。治疗后PAV组患者的1秒用力呼气容积/用力肺活量FEV1/FVC(76.13±1.67)、1秒用力呼气容积占预计值百分比(FEV1%)(70.68%±2.31%)、动脉血氧含量(110.41%±5.36%)ml/L、氧摄取率(40.28%±2.63%)及救治成功率(91.49%)高于PSV组[(60.72±3.14)、(69.92%±1.23%)、(78.59±5.33)ml/L]、(27.78%±1.52%)、76.09%,差异有统计学意义(P<0.05)。结论PAV可改善COPD急性发作患者氧代谢及肺功能状态,提高救治成功率并缩短住院时间,效果良好。

Objective To investigate the effect of non-invasive proportional assisted ventilation (PAV) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and its effects on oxygen metabolism and lung function.Methods A total of 93 patients with acute exacerbation of COPD in Heji Hospital Affiliated to changzhi Medieal Hospital from March 2016 to March 2018 were divided into two groups by random number table method, 46 patients in PSV group underwent routine pressure support ventilation (PSV), and 47 patients in PAV group were given non-invasive proportion of assisted ventilation. The survival rate and patient hospitalization and ventilator use time and post-treatment oxygen metabolism and lung function of successful patients in the two group were compared.Results In PAV group the hospital stay was (9.45±1.79) d, ventilator use time was (4.49±0.26) d;in the PSV group hospital stay was (13.12±1.68) d, ventilator use time was (5.86±0.32) d, which were significantly shorter than those in the PSV group, the differences were statistically significant (P<0.05). After treatment, The forced expiratory volume for 1 second/forced vital capacity (FEV1/FVC) level (76.13±1.67) and 1 second and expiratory volume as apercentage estimate (FEV1%) (70.68%±2.31%), arterial blood oxygen content [(110.41±5.36)ml/L], oxygen uptake rate (40.28%±2.63%) and treatment success rate (91.49%) in PAV group were higher than those in PSV group [(60.72±3.14), (69.92%±1.23%), (78.59±5.33)ml/L, (27.78%±1.52%), 76.09%], the differences were statistically significant (P<0.05).Conclusions PAV can improve the oxygen metabolism and pulmonary function in patients with acute exacerbation of COPD, improve the success rate of treatment and shorten the hospital stay, and the effect is good.