无创正压通气联合痰热清注射液在慢性阻塞性肺疾病急性加重期合并呼吸衰竭的临床研究

Clinical Study of Noninvasive Positive Pressure Ventilation Combined with Tanreqing Injection for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

目的观察无创正压通气联合痰热清注射液治疗慢性阻塞性肺疾病(COPD)急性加重期合并呼吸衰竭的临床疗效和安全性。方法COPD急性加重期合并呼吸衰竭患者98例随机分为实验组与对照组,两组均予以无创正压通气治疗,试验组联合静脉使用痰热清注射液,疗程2周。比较两组患者治疗前后血气分析指标、血清炎症指标、临床COPD问卷(CCQ)评分、不良反应方面的差异,同时比较两组在平均住院时间、气管插管率、病死率。结果治疗后,两组患者血气指标、血清炎症指标、CCQ评分较治疗前均显著改善(P<0.05),与对照组比较,试验组患者治疗后以上指标(动脉血p H值除外)改善更为显著(P<0.05)。与对照组相比,试验组平均住院时间显著降低(P<0.05),同时气管插管率、病死率亦有所降低,但差异无统计学意义(P>0.05)。两组均未出现明显不良反应。结论与单纯无创正压通气治疗比较,无创正压通气联合痰热清注射液治疗更能显著改善患者急性症状、血气指标、血清炎症指标,显著降低平均住院时间,并且安全性高。

Objective:To study the efficacy and safety of noninvasive positive pressure ventilation combined with Tanreqing Injection for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with respiratory failure.Methods:A total of 98 patients with AECOPD complicated with respiratory failure were randomly divided into the experimental group and control group.Both groups were treated with noninvasive positive pressure ventilation,and the experimental group was treated with Tanreqing Injection intravenously for two weeks.The differences of blood gas analysis index,serum inflammation index,CCQ score and adverse reactions between the two groups before and after treatment were compared.At the same time,the differences in average hospitalization time(days),tracheal intubation rate and mortality rate between the two groups were compared.Results:After treatment,the blood gas index,serum inflammation index and CCQ score of the two groups were significantly improved compared with those before treatment,and the differences were statistically significant(P<0.05).Compared with the control group,the above indicators(except arterial blood p H value)in the experimental group improved more significantly after treatment,the difference was statistically significant(P<0.05).Compared with the control group,the average length of stay(days)in the experimental group was significantly reduced(P<0.05),and the tracheal intubation rate and mortality rate were also decreased,but the difference was not statistically significant(P>0.05).There were no obvious adverse reactions in both groups.Conclusion:Compared with simple noninvasive positive pressure ventilation,noninvasive positive pressure ventilation combined with Tanreqing Injection can significantly improve the acute symptoms,blood gas indexes,serum inflammatory indicators,significantly reduce the average length of hospital stay,and has higher safety.