无创双水平气道正压通气治疗对老年慢性阻塞性肺疾病并发呼吸衰竭患者生活质量及血气指标的影响

Effect of bi-level positive airway pressure on the quality of life and blood gas index in elderly patients with chronic obstructive pulmonary disease complicated with respiratory failure

目的:探究无创双水平气道正压通气(BiPAP)治疗对老年慢性阻塞性肺疾病(COPD)并发呼吸衰竭患者生活质量及血气指标的影响。方法:选取2017年5月至2019年5月,本院收治的老年COPD并发II型呼吸衰竭患者96例,按随机数表法分两组,各48例。对照组行常规治疗,观察组在对照组基础上给予BiPAP治疗,均以7 d为1疗程,持续治疗2~4周。比较两组临床疗效、血气指标水平(PaO2、PaCO2、SaO2)、生活质量(SGRQ评分)、安全性。结果:观察组治疗总有效率(91.7%)高于对照组(70.8%),差异有统计学意义(χ2=6.838,P<0.05)。重复测量方差分析显示,两组PaO2、PaCO2、SaO2及SGRQ评分的时点、组间、时点与组别的交互效应,差异有统计学意义(P<0.05);治疗1周、末次治疗后,观察组PaO2、SaO2高于对照组,PaCO2低于对照组,差异有统计学意义(P<0.05);治疗后1个月、3个月,观察组呼吸症状、活动受限、疾病影响、SGRQ总分均低于对照组,差异有统计学意义(P<0.05)。两组并发症发生率(10.4%vs.6.3%)比较差异无统计学意义(P>0.05)。结论:BiPAP治疗老年COPD并发II型呼吸衰竭患者疗效显著,可明显改善血气指标,提高生活质量,且安全性高。

Objective:To investigate the effects of non-invasive bi-level positive airway pressure(Bi-PAP)on quality of life and blood gas parameters in elderly patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:Ninety-six patients with type 2 COPD complicated with type 2 respiratory failure were enrolled in our hospital from May 2017 to May 2019.They were divided into two groups according to the random number table method,48 cases each.The control group received routine treatment,and the study group received BiPAP treatment on the basis of the control group.All patients were treated with 7 days as a course of treatment for 2 to 4 weeks.The clinical efficacy,blood gas index levels(PaO2,PaCO2,SaO2),quality of life(SGRQ score),and safety were compared between the two groups.Results:The total effective rate of treatment in the study group(91.7%)was higher than that in the control group(70.8%),and the difference was statistically significant(χ2=6.838,P<0.05).Repeated measures analysis of variance showed that there were significant differences in the interaction time between the two groups of PaO2,PaCO2,SaO2 and SGRQ scores,between groups,time points and groups(P<0.05).After treatment for 1 week and the last treatment,PaO2and SaO2 in the study group were higher than those in the control group,and PaCO2 was lower than the control group,the difference was statistically significant(P<0.05).At 1 month and 3 months after treatment,the respiratory symptoms,activity limitation,disease effects,and SGRQ scores of the study group were lower than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(10.4%vs.6.3%,P>0.05).Conclusions:BiPAP is effective in the treatment of elderly patients with COPD complicated with type II respiratory failure,which can significantly improve blood gas index,improve quality of life,and has high safety.