无创正压通气联合布地奈德混悬剂雾化吸入治疗AECOPD并发Ⅱ型呼吸衰竭的效果及pH、PaO_(2)、PaCO_(2)改善情况分析

Analysis of the Effect of Non-invasive Positive Pressure Ventilation Combined with Budesonide Suspension Nebulized Inhalation in the Treatment of AECOPD Complicated with TypeⅡRespiratory Failure and the Improvement of pH,PaO_(2) and PaCO_(2)

目的分析对慢性阻塞性肺疾病急性加重期(AECOPD)并发Ⅱ型呼吸衰竭患者使用无创正压通气联合布地奈德混悬剂雾化吸入治疗的治疗效果,以及对pH、动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))影响。方法选取2017年1月-2020年7月收治的100例AECOPD并发Ⅱ型呼吸衰竭患者,编号随机抽取法将患者分为研究组和对照组,每组50例。研究组采用无创正压通气联合布地奈德混悬剂雾化吸入治疗,对照组采用布地奈德混悬剂雾化吸入治疗,对两组并发症、肺功能、临床指标进行对比,并评价两组治疗效果及炎症因子水平。结果研究组治疗总有效率96%比对照组优,差异有统计学意义(χ^(2)=6.061,P<0.05),肺功能比对照组优,差异有统计学意义(P<0.05),研究组肺部感染、低血压、低氧血症、气胸等并发症发生率2%低于对照组,差异有统计学意义(χ^(2)=5.983,P<0.05),临床指标优于对照组,差异有统计学意义(P<0.05),白细胞介素6(IL-6)、白细胞介素10(IL-10)、肿瘤坏死因子-α(TNF-α)水平比对照组低,差异有统计学意义(P<0.05)。结论对AECOPD并发Ⅱ型呼吸衰竭患者使用无创正压通气联合布地奈德混悬剂雾化吸入治疗,有效改善肺功能,改善呼吸频率等临床指标,减轻炎症,治疗效果显著,并发症低,安全性高,有效促进患者的康复。

Objective To analyze the therapeutic effect of noninvasive positive pressure ventilation combined with budesonide suspension inhalation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and typeⅡrespiratory failure,as well as to pH,arterial partial pressure of oxygen(PaO_(2)),carbon dioxide partial pressure(PaCO_(2))influence.Methods A total of 100 patients with AECOPD complicated with typeⅡrespiratory failure who were admitted from January 2017 to July 2020 were selected,and the patients were divided into a study group and a control group,with 50 cases in each group.The study group was treated with non-invasive positive pressure ventilation combined with budesonide suspension atomized inhalation treatment,and the control group was treated with budesonide suspension atomized inhalation treatment.The complications,lung function,and clinical indicators of the two groups were compared,and the therapeutic effects and inflammatory factors level of the two groups were evaluated.Results The total effective rate of treatment in the study group was 96%better than that of the control group,the difference was statistically significant(χ^(2)=6.061,P<0.05),the lung function was better than the control group,the difference was statistically significant(P<0.05),the incidence of complications such as lung infection,of the study group,hypotension,hypoxemia,and pneumothorax were 2%lower than the control group,the difference was statistically significant(χ^(2)=5.983,P<0.05),and the clinical indicators were better than the control group,the difference was statistically significant(P<0.05),the levels of interleukin 6(IL-6),interleukin 10(IL-10),and tumor necrosis factor-α(TNF-α)were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The use of noninvasive positive pressure ventilation combined with budesonide suspension aerosol inhalation therapy for patients with AECOPD complicated with typeⅡrespiratory failure can effectively improve lung function,improve respiratory frequency and other clinical indicators,reduce inflammation,and have significant therapeutic effects and low complications.It has high safety,effectively promotes the recovery of patients.