无创通气联合舒利迭治疗老年慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭临床效果分析

Clinical Effect Analysis of Non-invasive Ventilation Combined with Seretide in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Elderly Patients with TypeⅡRespiratory Failure

目的探讨沙美特罗替卡松吸入粉雾剂(舒利迭)与无创通气联合对老年慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的治疗效果。方法方便选取该院呼吸科2018年6月—2021年6月收治的88例老年慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者为研究对象,依据治疗方法分成两组,对照组(n=40)采取无创正压通气治疗,观察组(n=48)基于对照组加用舒利迭,比较两组临床疗效、肺功能及血气指标改善情况。结果观察组总有效率为91.67%,高于对照组75.00%,差异有统计学意义(χ^(2)=4.530,P<0.05);治疗后两组肺功能指标均比同组治疗前更高,且观察组FEV1为(1.30±0.35)L,FVC为(1.86±0.15)L,FEV1/FVC为(69.89±0.73)%,均明显优于对照组,差异有统计学意义(P<0.001);治疗后两组血气指标中pH值、SaO_(2)、PaO_(2)水平均比同组治疗前更高,且观察组分别为(7.42±0.10)、(90.56±6.49)%、(72.96±4.06)mmHg明显高于对照组;治疗后两组PaCO_(2)水平明显低于同组治疗前,且观察组(60.14±3.22)mmHg明显低于对照组,差异有统计学意义(P<0.001)。结论舒利迭与无创通气结合治疗AECOPD合并Ⅱ型呼吸衰竭临床疗效优良,对于呼吸功能与肺功能的改善作用突出,有推广价值。

Objective To investigate the therapeutic effect of salmeterol and ficasone inhalation powder inhalation(Seretide)combined with non-invasive ventilation in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with typeⅡrespiratory failure.Methods 88 elderly patients with acute exacerbation of chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure who were admitted to the Department of Respiratory Medicine in the hospital from June 2018 to June 2021 were conveniently selected as the study objects.Divided into two groups according to the treatment method,the control group(n=40)was treated with non-invasive positive pressure ventilation,and the observation group(n=48)was based on the control group plus seretide.The clinical efficacy,the improvement of lung function and blood gas indexes were compared between the two groups.Results The total effective rate of the observation group was 91.67%,which was higher than 75.00%that of the control group,the difference was statistically significant(χ^(2)=4.530,P<0.05).After treatment,the pulmonary function indexes in the two groups were higher than those in the same group before treatment,and the FEV1 was(1.30±0.35)L,the FVC was(1.86±0.15)L,and the FEV1/FVC was(69.89±0.73)%in the observation group,all significantly better than the control group,the difference was statistically significant(P<0.001).After treatment,the pH value,SaO_(2) and PaO_(2) levels of blood gas indexes in the two groups were higher than those in the same group before treatment.And the observation group was(7.42±0.10),(90.56±6.49)%,(72.96±4.06)mmHg significantly higher than the control group,after treatment,the levels of PaCO_(2) in the two groups were significantly lower than those in the same group before treatment,and the observation group(60.14±3.22)mmHg was significantly lower than the control group,the difference was statistically significant(P<0.001).Conclusion Seretide combined with non-invasive ventilation has excellent clinical curative effect in the treatment of AECOPD complicated with typeⅡrespiratory failure.