沙美特罗替卡松配合BIPAP呼吸机治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的临床观察

Effect of salmeterol tekasone combined with BIPAP ventilator on patients with COPD with type Ⅱ respiratory failure

目的:观察沙美特罗替卡松与双水平气道正压通气(BIPAP)呼吸机联合治疗慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭患者的疗效。方法:抽取122例2017年4月至2019年8月新乡市第一人民医院收治的COPD合并Ⅱ型呼吸衰竭患者为研究对象,依据不同治疗方法,将入选患者分为联合组及药物组,其中药物组(n=61例)行沙美特罗替卡松治疗,联合组(n=61例)在药物组的基础上联合BIPAP呼吸机治疗。观察两组患者的疗效,并比较治疗前后动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、酸碱度(pH)及运动能力[六米步行距离(6MWD)]。结果:药物组总有效率(83.61%)与联合组(98.36%)比较,差异有统计学意义(χ^2=8.093,P<0.05)。治疗前,两组患者各指标比较差异未见统计学意义(P>0.05);治疗后,联合组6MWD、PaCO2、pH值高于药物组,PaCO2低于药物组,差异有统计学意义(P<0.05)。结论:沙美特罗替卡松联合BIPAP呼吸机治疗COPDⅡ型呼吸衰竭疗效显著,可改善动脉血气指标。

Objective To observe the efficacy of salmeterol tekasone combined with bi-level positive airway pressure ventilation(BIPAP)ventilator in the treatment of chronic obstructive pulmonary disease(COPD)with type Ⅱ respiratory failure.Methods A total of 122 patients with COPD and type Ⅱ respiratory failure admitted in Xinxiang First People’s Hospital from April 2017 to August 2019 were selected as inquiry objects.According to different treatment methods,the selected patients were divided into combination group and drug group,in which the drug group(n=61)was treated with salmetrotecasone fluticasone,and the combined group(n=61 cases)was treated with BIPAP respirator on the basis of the drug group.The curative effect of the two groups was observed,and the arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2),pH and exercise ability[6 m walling distance(6MWD)]before and after treatment were compared.Results The total effective rate of the drug group(83.61%)was compared with that of the combined group(98.36%),and the difference between the two groups was significant(χ^2=8.093,P<0.05).Before treatment,there was no difference in each index between the two groups(P>0.05);after treatment,6MWD,PaCO2 and PH in the combined group were significantly higher than those in the drug group,and the difference was statistically significant(P<0.05).Conclusions Salmeterol fluticasone combined with BIPAP respirator is effective in the treatment of copd typeⅡrespiratory failure,which can significantly improve the arterial blood gas index.