重症慢阻肺合并Ⅱ型呼吸衰竭给予无创呼吸机序贯疗法的价值

The Value of Non-invasive Sequential Ventilator Therapy for Severe Chronic Obstructive Pulmonary Disease Combined with Type Ⅱ Respiratory Failure

目的探讨重症慢阻肺合并Ⅱ型呼吸衰竭给予无创呼吸机序贯疗法的价值。方法选择该院2018年3月—2021年3月间收治的60例重症慢阻肺合并Ⅱ型呼吸衰竭患者,以随机动态数表进行分组,每组30例。对照组实施有创呼吸机治疗,观察组实施无创呼吸机序贯疗法。对比分析两组患者的有创通气时间、总机械通气时间、住ICU时间以及治疗后的血气分析指标[血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)]以及生命体征(心率、呼吸频率)。结果观察组患者的有创通气时间为(8.34±2.45)d,总机械通气时间为(13.67±4.76)d,住ICU时间为(15.21±5.10)d,而对照组患者的有创通气时间为(13.28±8.23)d,总机械通气时间为(20.33±7.69)d,住ICU时间为(24.62±9.58)d,组间差异有统计学意义(t=3.151、4.033、4.749,P<0.05);观察组的PaO_(2)为(86.87±5.46)mmHg,PaCO_(2)为(50.12±2.56)mmHg,OI为(312.12±48.51)mmHg,心率为(83±5)次/min,呼吸频率为(16±3)次/min,对照组的PaO_(2)为(78.23±4.43)mmHg,PaCO_(2)为(66.76±3.54)mmHg,OI为(280.49±46.71)mmHg,心率为(92±7)次/min,呼吸频率为(20±5)次/min,组间差异有统计学意义(t=6.731、20.862、2.573、5.730、3.757,P<0.05)。结论无创呼吸机序贯疗法可在短时间内改善重症慢阻肺合并Ⅱ型呼吸衰竭患者的血气分析指标与生命体征,避免呼吸机依赖情况。

Objective To explore the value of non-invasive ventilator sequential therapy for severe chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure. Methods Sixty patients with severe chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure admitted to the hospital between March 2018 and March 2021 were selected and divided into groups with a random dynamic number table, with 30 cases in each group. The control group received invasive ventilator therapy, and the observation group received non-invasive ventilator sequential therapy. Compared and analyzed the invasive ventilation time, total mechanical ventilation time, stay in ICU, and blood gas analysis indexes after treatment of the two groups of patients [Partial pressure of oxygen(PaO_(2)), Partial pressure of arterial carbon dioxide(PaCO_(2)), Oxygenation index(OI)] and vital signs(heart rate, breathing rate). Results In the observation group, the invasive ventilation time was(8.34±2.45)d, the total mechanical ventilation time was(13.67±4.76) d, and the time spent in ICU was(15.21±5.10) d.In the control group, the invasive ventilation time was(13.28 ±8.23)d, the total mechanical ventilation time was(20.33 ±7.69) d, and the time spent in ICU was (24.62±9.58) d. The difference between the groups was statistically significant(t=3.151, 4.033, 4.749, P<0.05). In the observation group, PaO_(2)was(86.87±5.46) mmHg, PaCO_(2)was(50.12±2.56) mmHg, OI was(312.12±48.51) mmHg, heart rate was(83±5) beats/min, and breathing frequency was(16±3) times/min. In the control group, PaO_(2)was(78.23±4.43) mmHg,PaCO_(2)was(66.76 ±3.54) mmHg, OI was(280.49 ±46.71) mmHg, heart rate was(92 ±7) beats/min, and breathing frequency was(20±5) beats/min, the difference between groups was statistically significant(t=6.731, 20.862, 2.573,5.730, 3.757, P <0.05). Conclusion Non-invasive ventilator sequential therapy can improve the blood gas analysis indexes and vital signs of patients with severe COPD combined with type Ⅱ respiratory failure in a short period of time, and avoid ventilator dependence.