无创正压通气中SXX模式治疗对COPD合并Ⅱ型呼吸衰竭患者呼吸力学指标、肺功能及并发症的影响

Effects of SXX Mode Therapy in Non-invasive Positive Pressure Ventilation on Respiratory Mechanics Indexes,Lung Function and Complications of COPD Patients with Type Ⅱ Respiratory Failure

目的探讨无创正压通气中SXX模式治疗对慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者呼吸力学指标、肺功能及并发症的影响。方法回顾性分析2017年2月—2020年1月本院收治的108例COPD合并Ⅱ型呼吸衰竭患者的临床资料。根据通气模式不同分为观察组和对照组,每组45例。观察组给予SXX模式,对照组给予ST模式。比较2组治疗后呼吸力学、肺功能指标及并发症总发生率。结果与治疗前比较,2组治疗后血pH值、氧分压升高,二氧化碳分压下降,且观察组改善程度较对照组更显著(P<0.01)。与治疗前比较,2组潮气量增加,呼吸频率下降,且观察组变化较对照组更显著(P<0.05,P<0.01)。2组治疗前后每分通气量、吸气/呼吸周期时间组间及组内比较差异无统计学意义(P>0.05)。与治疗前比较,2组治疗后用力肺活量、第1秒用力呼气容积及第1秒用力呼气容积占用力肺活量百分比升高,且观察组高于对照组,差异有统计学意义(P<0.05,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)。结论无创正压通气中SXX模式治疗COPD合并Ⅱ型呼吸衰竭,在改善患者血气指标、稳定呼吸频率、降低二氧化碳潴留、促进肺功能恢复方面优于ST模式,有利于实现最佳通气效果。

Objective To explore effects of SXX mode therapy in non-invasive positive pressure ventilation(NIPPV)on respiratory mechanics indexes,lung function and complications of chronic obstructive pulmonary disease(COPD)patients with type Ⅱ respiratory failure.Methods Clinical data of 108 COPD patients with type Ⅱ respiratory failure admitted during February 2017 and January 2020 was retrospectively analyzed,and the patients were divided into observation group(n=45)and control group(n=45)according to different ventilation modes.Observation group received SXX mode,while control group received ST mode.Values of respiratory mechanics indexes,lung function indexes and the total incidence rate of complications after treatment were compared between two groups.Results Compared with those before treatment,values of blood pH value and oxygen partial pressure were significantly increased,while values of carbon dioxide partial pressure were significantly decreased after treatment in two groups,and the improved degrees of the above indicators were more significant in observation group than those in control group(P<0.01).Compared with those before treatment,tidal volumes were significantly increased,while values of respiratory frequency were significantly decreased after treatment in two groups,and the changes were more significant in observation group than those in control group(P<0.05,P<0.01).There were no significant differences in values of minute ventilation volume and the inspiratory/respiratory cycle time before and after treatment between inter-and intra-groups(P>0.05).Compared with those before treatment,levels of forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC were significantly increased after treatment in two groups,and the levels in observation group were significantly higher than those in control group(P<0.05,P<0.01).No significant difference was found in the total incidence rate of complications between two groups(P>0.05).Conclusion SXX mode in NIPPV is superior to ST mode in treatment of COPD patients with type Ⅱ respiratory failure with respect to improving blood gas indicators,stabilizing breathing rate,reducing CO 2 retention and promoting the recovery of lung function,which is conducive to achieving the optimal ventilation effect.