尼可刹米联合无创呼吸机治疗COPD合并Ⅱ型呼吸衰竭的临床疗效及安全性

Clinical efficacy and safety of nicoximide combined with non-invasive ventilator in the treatment of COPD complicated with typeⅡrespiratory failure

目的观察尼可刹米联合无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效及安全性。方法选择2018年1月-2019年7月湖南省安化县人民医院收治的COPD合并Ⅱ型呼吸衰竭患者114例,以随机数字表法分为观察组及对照组,每组57例。对照组在常规治疗的基础上给予双水平间歇无创正压通气治疗,观察组在对照组的基础上给予尼可刹米治疗。比较2组临床效果、治疗前后血气指标及不良反应。结果观察组临床总有效率高于对照组(91.23%vs.71.93%,χ^(2)=5.343,P=0.026);观察组住院时间短于对照组,治疗后心率(HR)、气管插管率低于对照组,治疗后呼吸频率(BR)高于对照组(P<0.01);治疗后,2组患者pH值、动脉血氧分压(Pa O_(2))均高于治疗前,动脉血二氧化碳分压(PaCO_(2))低于治疗前,且观察组变化幅度大于对照组,差异均有统计学意义(P<0.01);2组患者病死率、治疗相关不良反应发生率比较差异无统计学意义(P>0.05)。结论尼可刹米联合无创呼吸机治疗COPD合并Ⅱ型呼吸衰竭可显著提升临床疗效,加快术后康复,改善血气指标,且不增加不良反应。

Objective To observe the clinical efficacy and safety of nicosamide combined with non-invasive ventilator in the treatment of chronic obstructive pulmonary disease(COPD)with typeⅡrespiratory failure.Methods Selected 114 patients with COPD andⅡrespiratory failure admitted to the Anhua People’s Hospital,Hunan Province from January 2018 to July 2019,They were divided into observation group and control group by random number table,with 57 cases in each group.The control group was given bi-level intermittent non-invasive positive pressure ventilation on the basis of conventional treatment,and the observation group was given nikethamide therapy on the basis of the control group.The clinical effects,blood gas indexes before and after treatment and adverse reactions were compared between the two groups.Results The total clinical effective rate of the observation group was higher than that of the control group(91.23%vs.71.93%,χ^(2)=5.343,P=0.026);The observation group’s hospital stay was shorter than the control group,the heart rate(HR)and tracheal intubation rate after treatment were lower than the control group,and the respiratory frequency(BR)after treatment was higher than the control group(P<0.01);After treatment,the p H and arterial partial pressure of oxygen(PaO_(2))of the two groups were higher than before treatment,arterial partial pressure of carbon dioxide(PaCO_(2))was lower than before treatment,and the observation group changed more than the control group,the difference were statistically significant(P<0.01);There was no significant difference in mortality and treatment-related adverse reactions between the two groups(P>0.05).Conclusion Nicosamide combined with non-invasive ventilator in the treatment of COPD combined withⅡrespiratory failure can significantly improve the clinical efficacy,speed up postoperative recovery,improve blood gas indicators,and do not increase adverse reactions.