无创机械通气联合沙美特罗丙酸氟替卡松吸入剂治疗老年慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的效果

Effect of non-invasive ventilator combined with salmeterol fluticasone propionate inhalation on elderly COPD patients with typeⅡrespiratory failure

目的探讨无创机械通气联合沙美特罗丙酸氟替卡松吸入剂治疗老年慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者的临床效果。方法选择2017年2月至2019年3月我院治疗的COPD合并Ⅱ型呼吸衰竭患者143例,使用随机数表法把患者分为对照组(72例)和治疗组(71例)。对照组采用无创机械通气治疗,治疗组在对照组治疗基础上增加沙美特罗丙酸氟替卡松吸入剂治疗。观察两组治疗的临床效果、血气指标、炎性因子指标、肺功能情况和不良反应情况。结果对照组治疗总有效率明显比治疗组低(P<0.05);与治疗前相比,治疗后两组血气指标均显著改善(P<0.05),且治疗组血气指标改善状况明显优于比对照组(P<0.05);与治疗前相比,治疗后两组炎性因子指标均显著改善(P<0.05),治疗组炎性因子指标改善效果明显优于对照组(P<0.05);与治疗前相比,治疗后两组肺功能指标均显著提高(P<0.05),且治疗组肺功能指标明显高于对照组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论无创机械通气联合沙美特罗丙酸氟替卡松吸入剂治疗老年COPD合并Ⅱ型呼吸衰竭患者,减轻患者炎性反应水平,增强肺功能,明显改善患者临床症状和血气指标。

Objective To analyze the clinical effect of non-invasive ventilator combined with salmeterol fluticasone propionate inhalation on elderly patients with chronic obstructive pulmonary disease(COPD)complicated with type II respiratory failure.Methods One hundred and forty three COPD patients with type II respiratory failure treated in our hospital from February 2017 to March 2019 were selected and randomly divided into control group(72 cases)and treatment group(71 cases)by random number table method.The control group was treated with non-invasive ventilator,while the treatment group was treated with salmeterol propionate fluticasone inhalation in addition to the control group.The clinical effect,blood gas index,inflammatory factor index,pulmonary function and adverse reactions of the two groups were observed and compared.Results The total effective rate of the control group was significantly lower than that of the treatment group(P<0.05).Compared with before treatment,the blood gas indexes of the two groups were significantly improved after treatment(P<0.05),and the improvement of blood gas indexes of the treatment group was significantly better than that of the control group after treatment(P<0.05).Compared with before treatment,the inflammatory factor indexes of the two groups were significantly improved after treatment(P<0.05),and the improvement effect of the inflammatory factor indexes of the treatment group was significantly better than that of the control group after treatment(P<0.05).Compared with before treatment,the lung function indexes of the two groups were significantly improved after treatment(P<0.05),and the lung function indexes of the treatment group were significantly higher than those of the control group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Non-invasive ventilator combined with salmeterol fluticasone propionate inhalant for the treatment of elderly COPD patients complicated with type II respiratory failure can reduce the inflammatory response level of patients,enhance lung function,improve significantly the clinical symptoms and blood gas indexes of patients.