双水平气道正压通气在老年COPD伴呼吸衰竭患者的应用效果

Application Effect of Bilevel Positive Airway Pressure in Elderly Patients with COPD and Respiratory Failure

目的:探讨双水平气道正压通气(BiPAP)对老年慢性阻塞性肺疾病(COPD)伴呼吸衰竭患者血气指标的影响及安全性。方法:收集本院2019年5月~2020年7月收治的COPD合并呼吸衰竭患者88例,采用随机数字法分为对照组和观察组,各44例。对照组给予持续低流量鼻导管吸氧。观察组采用BiPAP呼吸机治疗。比较两组干预前后PaO_(2)、PaCO_(2)、HR变化及并发症。结果:干预前,两组PaO_(2)、PaCO_(2)、HR比较差异无统计学意义(P>0.05);观察组干预后PaO_(2)高于对照组,PaCO_(2)、HR低于对照组,差异有统计学意义(P<0.05);观察组总有效率(86.36%)高于对照组(65.91%),差异有统计学意义(P<0.05);两组临床并发症比较(对照组9.09%,观察组18.18%)差异无统计学意义(P>0.05)。结论:BiPAP呼吸机可显著改善COPD合并呼吸衰竭患者临床症状及血气指标,干预效果满意,安全性高。

Objective:To investigate the effect and safety of bilevel positive airway pressure(BiPAP)on blood and blood indexes in elderly patients with chronic obstructive pulmonary disease(COPD)and respiratory failure.Methods:88 COPD patients with respiratory failure admitted to our hospital from May 2019 to July 2020 were randomly divided into control group and observation group,44 cases in each group.The control group was given continuous low flow nasal catheter oxygen inhalation.The observation group was treated with BiPAP.The changes of PaO_(2),PaCO_(2),HR and complications were compared between the two groups before and after intervention.Result:Before intervention,there was no significant difference in PaO_(2),PaCO_(2) and HR between the two groups(P>0.05);after intervention,PaO_(2) in the observation group was higher than that in the control group,while PaCO_(2) and HR were lower than those in the control group(P<0.05);the total effective rate of the observation group(86.36%)was higher than that of the control group(65.91%)(P<0.05);there was no significant difference in clinical complications between the two groups(9.09%in the control group and 18.18%in the observation group)(P>0.05).Conclusion:BiPAP ventilator can significantly improve the clinical symptoms and blood gas indexes of COPD patients with respiratory failure.The intervention effect is satisfactory and the safety is high.