大-小无创序贯治疗时不同参数对COPD患者治疗效果的研究

Effect of different parameters on the patients with Chronic Obstructive Pulmonary Disease(COPD)during large-small noninvasive sequential treatment

目的探究大-小无创正压通气序贯治疗时,不同参数在COPD合并Ⅱ型呼吸衰竭稳定期患者中的应用效果。方法选择2016年9月—2018年9月某三甲医院住院的COPD患者160例,通过随机数字表法分为A、B、C和对照组,各40例,进行不同的参数调节,对患者血气分析中的PH值、PO_(2)、PCO_(2),心率值、呼吸值、SpO_(2)值、置换失败率、主观不适感及胃肠胀气发生率进行对比。结果与对照组相比较,A组在不适感及胃肠胀气的发生率差异具有统计学意义(P<0.05)。B组在血气分析值PO_(2)、PCO_(2)、SpO_(2)值、置换失败率、不适感及胃肠胀气的发生率差异具有统计学意义(P<0.05),C组在血气分析值PO_(2)、PCO_(2)、SpO_(2)、置换失败率差异具有统计学意义(P<0.05)。结论在COPD合并Ⅱ型呼吸衰竭患者稳定期进行大-小无创呼吸机置换时,IPAP、EPAP维持不变,调整Trigger-low/Cycle-high,可以作为选择参数的标准。

Objective To explore the application effects of different parameters in patients with COPD and type Ⅱ respiratory failure in stable stage during the sequential treatment of large-small noninvasive positive pressure ventilation.Methods 160 COPD patients who had been admitted in a tertiary hospital from Sept.2016 to Sept.2018 were selected,and were randomly diveded into four groups(A,B,C and control group),40 cases in each group had been conducted different parameter setting methods separately,and the PH value of Blood Gas Analysis,PO_(2),PCO_(2),heart rate,respiratory value,SpO_(2)value,replacement failure rate,subjective discomfort,incidence rate of gastrointestinal flatulence of the four groups were compared.Results Compared with the control group,the difference in the incidence of discomfort and flatulence in group A was statistically significant(P<0.05);group B had statistically significant differences in blood gas analysis values PO_(2),PCO_(2),SpO_(2),replacement failure rate,discomfort,and incidence of flatulence(P<0.05);and group C had statistically significant differences in blood gas analysis values PO_(2),PCO_(2),SpO_(2),and replacement failure rate(P<0.05).Conclusion When performing major-minor noninvasive ventilator replacement on patients diagnosed COPD with Type II respiratory failure,IPAP and EPAP is kept constant,Trigger-low/Cycle-high switch is adjusted,which can be used as the standard to select parameters.