胸腔闭式引流+BiPAP呼吸机辅助治疗COPD呼衰合并中-大量胸腔积液患者的效果评价

Efficacy of thoracic close drainage and BiP AP ventilator in the treatment of COPD and respiratory failure patients complicated with moderate to massive pleural effusion

目的:探讨胸腔闭式引流+BiPAP呼吸机辅助通气在慢性阻塞性肺疾病(COPD)呼衰合并中-大量胸腔积液(PE)患者中的应用效果。方法:83例COPD呼衰合并中-大量PE患者,随机分成两组,均接受综合对症治疗。对照组41例,采用BiPAP呼吸机辅助通气治疗;研究组42例,采用胸腔闭式引流+BiPAP呼吸机辅助通气治疗,比较两组治疗前、治疗5 d后的动脉血气指标、肺功能、住院时间。结果:治疗5 d后,研究组PaO2高于对照组,PaCO2低于对照组(P<0.05);FVC、FEV1高于对照组,RV/TLC低于对照组(P<0.05);住院时间短于对照组(P<0.05)。结论:胸腔闭式引流+BiPAP呼吸机辅助通气治疗COPD呼衰合并中-大量PE患者,可改善患者动脉血气,增强肺功能,促进患者康复。

Objective:To investigate the efficacy of thoracic close drainage together with BiPAP ventilator in chronic obstructive pulmonary disease(COPD)and respiratory failure patients complicated with moderate to massive pleural effusion(PE).Methods:A total of 83 COPD and respiratory failure patients complicated with moderate to massive pleural effusion(PE)were randomized into 2 groups,and all received comprehensive symptomatic treatment.On this basis,the control group(41 cases)were treated with BiPAP ventilator,while the study group(42 cases)were treated with close drainage of thoracic cavity and BiPAP ventilator.The arterial blood gas indexes and pulmonary function before treatment and 5 d after treatment,and hospital stays were compared between the two groups.Results:After 5 d of treatment,the PaO2 level of the study group was higher than that of the control group,and PaCO2 level was lower than that of the control group(P<0.05);levels of FVC and FEV1 in the study group were higher than those in the control group,and RV/TLC levels were lower than those in the control group;and hospital stay of the study group was shorter than that of the control group(P<0.05).Conclusion:In the treatment of COPD and respiratory failure patients complicated with moderate to massive PE,thoracic closed drainage and BIPAP ventilator can improve the arterial blood gas,enhance pulmonary function,and promote the recovery of patients.