双水平正压无创机械通气对慢阻肺合并呼吸衰竭患者的影响

Effect of Bi Level Positive Pressure Noninvasive Mechanical Ventilation on Patients with Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

目的:探讨双水平正压无创机械通气对慢性阻塞性肺疾病(慢阻肺)合并呼吸衰竭患者的影响。方法:将2019年4月-2020年4月作为病例纳入时间,研究对象为70例在北京市昌平区医院接受相关治疗的慢阻肺合并呼吸衰竭患者,采取随机数字表法分为对照组与试验组,各35例,分别接受常规治疗及双水平正压无创机械通气治疗。对两组治疗前及治疗72 h后的动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、降钙素原(PCT)、C反应蛋白(CRP)、心率(HR)、呼吸频率(RR)、峰值呼气流速(PEF)的变化情况,以及呼吸困难症状改善情况、住院时间进行观察。结果:相比于治疗前,治疗72 h后,两组的各项指标均改善,治疗72 h后,试验组的PaO_(2)高于对照组,PaCO_(2)、PCT、CRP低于对照组,PEF快于对照组,HR、RR慢于对照组,差异均有统计学意义(P<0.05);治疗3、7 d后,试验组的呼吸困难发生率明显低于对照组,差异有统计学意义(P<0.05);试验组住院时间明显短于对照组,差异有统计学意义(P<0.05)。结论:双水平正压无创机械通气对慢阻肺合并呼吸衰竭患者具有积极影响,不仅能够提升PaO_(2)、PEF,降低PaCO_(2)、PCT、CRP、HR及RR,并且能够改善呼吸困难症状,缩短住院时间。

Objective:To investigate the effect of bi level positive pressure noninvasive mechanical ventilation on patients with chronic obstructive pulmonary disease complicated with respiratory failure.Method:Taking April 2019 to April 2020 as the case inclusion time,70 patients with chronic obstructive pulmonary disease complicated with respiratory failure who received relevant treatment in Beijing Changping District Hospital were divided into the control group and the experimental group by random number table method,35 patients in each group,receiving conventional treatment and bi level positive pressure noninvasive mechanical ventilation,respectively.The changes of arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2)),procalcitonin(PCT),C-reactive protein(CRP),heart rate(HR),respiratory rate(RR),peak expiratory flow rate(PEF)before and 72 h after treatment and the improvement of dyspnea symptoms,hospital stay were observed in the two groups.Result:Compared with those before treatment,all indicators of the two groups were improved after 72 hours of treatment.After 72 hours of treatment,PaO_(2)of the experimental group was higher than that of the control group,PaCO_(2),PCT,CRP were lower than those of the control group,PEF was faster than that of the control group,and HR and RR were slower than those of the control group,and the differences were statistically significant(P<0.05).After 3 and 7 days of treatment,the incidence of dyspnea in the experimental group was significantly lower than that in the control group(P<0.05).The hospital stay of the experimental group was significantly shorter than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Bi level positive pressure noninvasive mechanical ventilation has a positive effect on patients with chronic obstructive pulmonary disease complicated with respiratory failure.It can not only improve PaO_(2)and PEF,reduce the levels of PaCO_(2),PCT,CRP,HR and RR,but also improve the symptoms of dyspnea and shorten the length of hospital stay.