双水平气道正压无创呼吸机联合尼可刹米治疗急性加重期慢性阻塞性肺病合并Ⅱ型呼吸衰竭患者的临床疗效

The clinical efficacy of BiPAP non-invasive ventilator combined with nikethamide in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease complicated with type II respiratory failure

目的探讨双水平气道正压(BiPAP)无创呼吸机联合尼可刹米治疗急性加重期慢性阻塞性肺病(慢阻肺)合并Ⅱ型呼吸衰竭患者的临床疗效。方法给予BiPAP无创呼吸机治疗(对照组)和BiPAP无创呼吸机联合尼可刹米治疗(观察组)的急性加重期慢阻肺合并Ⅱ型呼吸衰竭患者各58例。记录两组临床疗效、住院时间、气管插管情况,比较两组治疗前及治疗7 d后血气分析指标、非气管插管者肺功能指标、炎症反应差异。结果观察组临床疗效优于对照组,住院时间、气管插管低于对照组(P<0.05)。治疗7 d后,两组部分血气分析指标、非气管插管者肺功能指标均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05);PaCO2、炎症反应较治疗前降低,且观察组低于对照组(P<0.05)。结论BiPAP无创呼吸机联合尼可刹米治疗急性加重期慢阻肺合并Ⅱ型呼吸衰竭效果显著,能提高患者肺功能,减少气管插管,改善血气分析,于减轻机体炎症反应也有积极意义。

Objective To explore the clinical efficacy of bi-level positive airway pressure(BiPAP)non-invasive ventilator combined with nikethamide in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated with type II respiratory failure.Methods Clinical data of 58 patients with acute exacerbation of COPD and type II respiratory failure who were treated with BiPAP non-invasive ventilator(control group)or BiPAP non-invasive ventilator combined with nikethamide(observation group)were retrospectively analyzed.The clinical efficacy,hospital stay and tracheal intubation were recorded.The blood gas analysis indexes,pulmonary function indicators of patients without tracheal intubation and inflammatory response were compared between the two groups before treatment and after 7 days of treatment.Results The clinical efficacy in the observation group was significantly better than that in the control group(P<0.05),and the hospital stay and tracheal intubation were shorter or lower than those in the control group(P<0.05).After 7 days of treatment,the partial blood gas analysis indexes such as PaO2 and pH and pulmonary function indicators such as FVC,FEV1 and PEF in patients without tracheal intubation in the two groups were higher than those before treatment(P<0.05),and the indexes in the observation group were higher than those in the control group(P<0.05).PaCO2 and inflammatory response such as CRP,PCT,sTREM-1 and HMGB-1 were lower than those before treatment(P<0.05),and the indexes in the observation group were lower than those in the control group(P<0.05).Conclusion BiPAP non-invasive ventilator combined with nikethamide has significant effects in the treatment of acute exacerbation of COPD with type II respiratory failure.It can improve the lung function,reduce the tracheal intubation,and improve the blood gas status.It also has a positive significance in reducing the body inflammatory response.