早期联合应用无创正压通气对AECOPD合并Ⅱ型呼吸衰竭患者疗效、血气分析指标及CAT评分的影响

Effects of Early Combined Application of Noninvasive Positive Pressure Ventilation on Clinical Efficacy,Blood Gas Analysis Indexes and CAT Scores in Patients with AECOPD Combined with TypeⅡRespiratory Failure

目的分析早期联合应用无创正压通气(NIPPV)对慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者的疗效、血气分析指标及慢性阻塞性肺病评估测试(CAT)评分的影响。方法选取2017年1月—2020年3月我院收治的168例AECOPD合并Ⅱ型呼吸衰竭患者,按照治疗方法的不同分为NIPPV组85例及对照组83例。对照组予呼吸科常规治疗,而NIPPV组在上述治疗基础上联合应用NIPPV治疗。比较2组治疗前及治疗24、72 h后生命体征[心率(HR)、呼吸频率(RR)、动脉血氧饱和度(SaO_(2))],CAT评分及血气分析指标[pH、脉搏二氧化碳分压(PaCO_(2))、脉搏氧分压(PaO_(2))]水平;比较2组临床疗效、总住院天数及并发症发生情况。结果治疗后,随着观察时间的延长2组HR、RR、CAT评分、PaCO_(2)均逐渐降低,SaO_(2)、pH、PaO_(2)逐渐升高,且NIPPV组治疗后各时间点HR、RR、CAT评分、PaCO_(2)均低于对照组,SaO_(2)、pH、PaO_(2)均高于对照组,差异均有统计学意义(P<0.05)。NIPPV组临床有效率高于对照组,总住院天数较对照组短,差异有统计学意义(P<0.05或P<0.01)。2组并发症总发生率比较差异无统计学意义(P>0.05)。结论早期联合应用NIPPV治疗可及时有效改善AECOPD合并Ⅱ型呼吸衰竭患者血气分析指标水平,降低CAT评分,且临床疗效佳、并发症少、住院时间短。

Objective To analyze effects of early combined application of noninvasive positive pressure ventilation(NIPPV)on clinical efficacy,blood gas analysis indexes and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in patients with acute exacerbation COPD(AECOPD)combined with typeⅡrespiratory failure.Methods A total of 168 patients with AECOPD combined with typeⅡrespiratory failure admitted during January 2017 and March 2020were selected,and they were divided into NIPPV group(n=85)and control group(n=83)according to different treatment methods.Control group was given routine treatment in respiratory department,while NIPPV group was given combined NIPPV treatment on the basis of the above treatment.Levels of vital signs[heart rate(HR),respiratory rate(RR)and arterial oxygen saturation(SaO_(2))],CAT score and blood gas analysis indexes[pH,partial pressure of carbondioxide(PaCO_(2))and pulse oxygen partial pressure(PaO_(2))]before and at the 24 th h and 72 th h after treatment were compared between two groups.Clinical efficacy,the total hospitalization days and incidence rate of complications were compared between two groups.Results After treatment,HR,RR and CAT scores and PaCO_(2) levels were gradually decreased,while SaO_(2),pH and PaO_(2) levels were gradually increased with prolonging observation time in two groups;at different treatment points after treatment in NIPPV group,levels of HR,RR,CAT score and PaCO_(2) were significantly lower,while SaO_(2),pH and PaO_(2) levels were significantly higher than those in control group(P<0.05).In NIPPV group,clinical efficiency was significantly higher,and the total hospitalization days was significantly shorter than those in control group(P<0.05 or P<0.01).There was no significant difference in the total incidence rate of complications between two groups(P>0.05).Conclusion Early combined application of NIPPV may improve levels of arterial blood gas analysis indexes and reduce CAT score of AECOPD patients with typeⅡrespiratory failure in time,and it may achieve better clinical efficacy,fewer complications and shorter of hospitalization days.