BiPAP通气联合异丙托溴铵雾化治疗COPD伴Ⅱ型呼吸衰弱患者的疗效评价

Evaluation of the curative effect of BiPAP ventilation combined with ipratropium bromide nebulization in the treatment of COPD patients with typeⅡrespiratory weakness

目的:探讨慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)合并Ⅱ型呼吸衰弱患者采用双水平气道正压(Bi-level positive airway pressure,BiPAP)通气联合异丙托溴铵雾化治疗的临床效果。方法:选取128例我院就诊的COPD伴Ⅱ型呼吸衰弱患者,随机分为两组(试验组64例、参照组64例),两组均给予抗感染、化痰、止咳等常规治疗,参照组给予异丙托溴铵雾化治疗,试验组在参照组基础上联合BiPAP通气治疗。比较两组临床疗效、治疗前、治疗2周后肺功能指标[FVC(用力肺活量)、FEV1(第1秒用力呼气容积)、RV(残气量)、TLC(肺总量)]水平、血清氧化应激指标[MDA(丙二醛)、SOD(超氧化物歧化酶)、GSH-Px(谷胱甘肽过氧化物)]水平、血气指标[_(PaO_(2)(脉)血氧分压)、PaCO_(2)(二氧化碳分压)、pH]水平。结果:试验组治疗总有效率较参照组高(P<0.05);与参照组相比,治疗2周后试验组FVC、FEV1较高,RV、TLC较低(P<0.05);与参照组相比,治疗2周后试验组血清GSH-Px、SOD、PaO_(2)、pH较高,MDA、PaCO_(2)较低(P<0.05)。结论:BiPAP通气联合异丙托溴铵雾化治疗COPD伴Ⅱ型呼吸衰弱患者疗效显著,可有效促进肺部血气状态及氧化应激状态改善,恢复肺功能。

Objective:To investigate the clinical effect of bilevel positive airway pressure(BiPAP)ventilation combined with ipratropium bromide aerosol therapy in patients with chronic obstructive pulmonary disease(COPD)combined with typeⅡrespiratory failure.Methods:A total of 128 patients with COPD and type II respiratory failure in our hospital were selected and randomly divided into two groups(64 in the test group and 64 in the reference group).Both groups were given conventional treatments such as anti-infection,phlegm,and cough relieving,and the reference group was given Nebulized ipratropium bromide therapy,the test group combined BiPAP ventilation therapy on the basis of the reference group.The clinical efficacy,lung function indexes[FVC(forced vital capacity),FEV1(forced expiratory volume in the first second),RV(residual volume),TLC(total lung volume)]levels,serum levels,Oxidative stress indicators[MDA(malondialdehyde),SOD(superoxide dismutase),GSH-Px(glutathione peroxide)]levels,blood gas indicators[PaO_(2)(pulse oxygen partial pressure),PaCO_(2)(Carbon dioxide partial pressure),pH]levels before and 2 weeks after treatment were compared between the two groups.Results:The total effective rate of treatment in the test group was higher than that in the reference group(P<0.05).Compared with the reference group,the test group had higher FVC and FEV1 after 2 weeks of treatment,and lower RV and TLC(P<0.05).Compared with the reference group After 2 weeks of treatment,the serum GSH-Px,SOD,PaO_(2),and pH of the test group were higher,while MDA and PaCO_(2) were lower(P<0.05).Conclusion:BiPAP ventilation combined with ipratropium bromide nebulization has a significant effect in the treatment of COPD patients with type II respiratory failure.It can effectively promote the improvement of pulmonary blood gas status and oxidative stress,and restore lung function.