无创呼吸机联合氧气驱动雾化吸入对慢性阻塞性肺疾病合并呼吸衰竭患者肺功能及血气分析指标的影响

Effects of non-invasive ventilator combined with oxygen-driven nebulized inhalation on lung function and blood-gas indexes in patients with chronic obstructive pulmonary disease complicated by respiratory failure

目的分析无创呼吸机联合氧气驱动雾化吸入对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者肺功能及血气分析指标的影响。方法抽取2020年1月至2021年7月周口市中心医院收治的COPD合并呼吸衰竭患者158例,按随机数字表法分为雾化组与无创通气组,每组79例。无创通气组采用无创呼吸机治疗,雾化组采用无创呼吸机联合氧气驱动雾化吸入治疗。比较两组疗效、症状改善时间、肺功能、血气分析指标、炎性因子水平、不良反应发生率。结果雾化组总有效率(97.47%,77/79)高于无创通气组(82.28%,65/79),P<0.05;雾化组症状改善时间短于无创通气组(P<0.05)。治疗后,两组肺功能均较治疗前改善,且雾化组改善情况优于无创通气组(P<0.05)。治疗后,雾化组动脉血二氧化碳分压(PaCO_(2))低于无创通气组,动脉血氧分压(PaO2)、动脉血氧饱和度(SaO_(2))高于无创通气组(P<0.05)。治疗后,两组炎性因子水平均较治疗前降低,且雾化组炎性因子水平低于无创通气组(P<0.05)。雾化组不良反应发生率(3.80%,3/79)低于无创通气组(12.66%,10/79),P<0.05。结论COPD合并呼吸衰竭患者采用无创呼吸机联合氧气驱动雾化吸入治疗效果显著,可减轻炎性反应,改善肺功能和血气分析指标,缩短症状改善时间,并可降低不良反应发生率。

Objective To analyze the effects of non-invasive ventilator combined with oxygen-driven nebulized inhalation on lung function and blood-gas indexes in patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure.Methods A total of 158 patients with COPD complicated by respiratory failure treated in Zhoukou Central Hospital from January 2020 to July 2021 were selected,and they were divided into nebulization group and non-invasive ventilation group according to random number table method,with 79 cases in each group.The non-invasive ventilation group was treated by non-invasive ventilator,and the nebulization group was treated by non-invasive ventilator combined with oxygen-driven nebulized inhalation.The curative effect,time of symptom improvement,lung function,blood-gas indexes,inflammatory factor level,and incidence of adverse reactions were compared between the two groups.Results The total effective rate of nebulization group was 97.47%(77/79),higher than the 82.28%(65/79)of non-invasive ventilation group(P<0.05).The improvement time of symptoms in nebulization group was shorter than that in non-invasive ventilation group(P<0.05).After treatment,the pulmonary function of the two groups were improved,compared with those before treatment,and the improvement in the nebulization group was better than that in the non-invasive ventilation group(P<0.05).After treatment,the arterial partial pressure of carbon dioxide in nebulization group was lower than that in non-invasive ventilation group,while the arterial partial pressure of oxygen and arterial saturation of oxygen were higher than those in non-invasive ventilation group(P<0.05).After treatment,the levels of inflammatory factors in both groups were lower than those before,and the levels of inflammatory factors in nebulization group were lower than those in non-invasive ventilation group(P<0.05).The incidence of adverse symptoms in nebulization group was 3.80%(3/79),which was lower than the 12.66%(10/79)in non-invasive ventilation group(P<0.05).Conclusions Non-invasive ventilator combined with oxygen-driven nebulized inhalation is effective in the treatment of COPD patients with respiratory failure.It can reduce inflammatory reaction,improve pulmonary function and blood-gas indexes,shorten the time of symptom improvement,and reduce the incidence of adverse reactions.