老年重症肺炎患者应用BiPAP治疗的效果

Effect of BiPAP treatment on elderly patients with severe pneumonia

目的:评价老年重症肺炎患者应用无创双水平气道正压通气(BiPAP)治疗的效果。方法:抽取2017年4月至2020年6月开封市中医院收治的老年重症肺炎患者80例,按随机数字表法分为研究组与对照组,每组40例。对照组采用鼻导管低流量吸氧,研究组采用BiPAP治疗。比较两组疗效、临床症状改善时间和治疗前后肺功能、血气水平。结果:研究组总有效率(95.00%,38/40)高于对照组(80.00%,32/40),差异有统计学意义(P<0.05)。研究组发热消退时间、肺部啰音消失时间、咳嗽消失时间、白细胞计数恢复时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,两组第1秒用力呼气容积、用力肺活量、最高呼气峰流速均较治疗前升高,且研究组高于对照组(P<0.05)。治疗后,两组动脉血二氧化碳分压(PaCO 2)均较治疗前降低,动脉血氧分压(PaO 2)、氧合指数(OI)均较治疗前升高,且研究组PaCO 2低于对照组,PaO 2、OI高于对照组(P<0.05)。结论:BiPAP治疗老年重症肺炎患者效果显著,可调节患者血气水平,改善临床症状,提高肺功能。

Objective To analyze the clinical effect of bilevle positive airway pressure(BiPAP)treatment on elderly patients with severe pneumonia.Methods A total of 80 elderly patients with severe pneumonia treated in Kaifeng Hospital of Traditional Chinese Medicine from April 2017 to June 2020 were selected and divided into study group and control group according to random number table method,with 40 cases in each group.The control group was given nasal catheters for low-flow oxygen inhalation,and the study group was treated by BiPAP.The efficacy,clinical symptoms improvement time,preoperative and postoperative lung function,blood gas level were compared between the two groups.Results The total effective rate of the study group(95.00%,38/40)was higher than that of the control group(80.00%,32/40),P<0.05.The fever-abatement time,pulmonary rales disappeared time,cough disappeared time,white blood cell count recovery time of the study group were shorter than those of the control group(P<0.05).After treatment,the forced expiratory volume in one second,forced vital capacity,peak expiratory flow of the two groups were higher than before treatment,and those indexes in the study group were higher than those in the control group(P<0.05).Compared to those before treatment,arterial partial pressure of carbon dioxide(PaCO2)of the two groups were lower,while arterial partial pressure of oxygen(PaO2)and oxygenation index(OI)were higher after treatment(P<0.05).And postoperative PaCO2 of the study group was lower than that of the control group,while postoperative PaO2 and OI were higher than those of the control group(P<0.05).Conclusions BiPAP is effective in the treatment of elderly patients with severe pneumonia.It can regulate blood gas levels,improve clinical symptoms,and promote lung function.