无创呼吸机通气联合乙酰半胱氨酸溶液吸入治疗老年呼吸衰竭合并高碳酸血症的效果及安全性

Efficacy and Safety of Non-Invasive Ventilator Ventilation Combined with Acetylcysteine Solution Inhalation in the Treatment of Elderly Patients with Respiratory Failure with Hypercapnia

目的探讨无创呼吸机通气联合乙酰半胱氨酸溶液吸入治疗老年呼吸衰竭合并高碳酸血症的效果及安全性。方法选取2020年1月—2021年12月收治的老年呼吸衰竭合并高碳酸血症98例,依据治疗方案不同将其分为观察组(56例)和对照组(42例)2组。观察组采用无创呼吸机通气联合乙酰半胱氨酸溶液吸入治疗,对照组采用无创呼吸机通气联合常规治疗。比较2组治疗后临床效果,治疗前后肺功能指标(第1秒用力呼气容积、第1秒用力呼气容积占用力肺活量百分比)、血气分析指标[氧合指数(OI)、动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))]和炎性因子(降钙素原、C反应蛋白),以及治疗期间不良反应发生情况。结果治疗后,总有效率观察组为96.43%高于对照组83.33%(P<0.05)。治疗前,2组肺功能指标、血气分析指标和炎性因子比较差异均无统计学意义(P>0.05)。治疗后,肺功能指标和OI、PaO_(2)2组均高于治疗前,且观察组均高于对照组;PaCO_(2)和炎性因子2组均低于治疗前,且观察组均低于对照组(P<0.05)。治疗期间,总不良反应发生率观察组为7.14%低于对照组23.81%(P<0.05)。结论无创呼吸机通气联合乙酰半胱氨酸溶液吸入治疗老年呼吸衰竭合并高碳酸血症临床效果显著,可改善患者肺功能和血气分析指标,抑制炎症反应,且安全性较好。

Objective To explore the efficacy and safety of non-invasive ventilator ventilation combined with acetylcysteine solution inhalation in the treatment of elderly patients with respiratory failure complicated with hypercapnia.Methods A total of 98 elderly patients with respiratory failure complicated with hypercapnia who were admitted to the hospital from January 2020 to December 2021 were selected,and they were divided into control group(n=42)and observation group(n=56)according to different treatment regimens.The observation group was given non-invasive ventilator ventilation and inhalation of acetylcysteine solution,and the control group was given non-invasive ventilator ventilation combined with conventional treatments.The clinical efficacy,the pulmonary function indicators[forced expiratory volume in one second(FEV1),forced expiratory volume in first second/forced vital capacity(FEV1/FVC)],blood gas indicators[oxygenation index(OI),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]and inflammatory factors[procalcitonin(PCT),C-reactive protein(CRP)]before and after treatment were compared in the two groups,and the total incidence rate of adverse reactions was recorded.Results The total effective rate of the observation group was 96.43%,which was higher than 83.33%of the control group(P<0.05).There were no significant differences in pulmonary function indicators,blood gas indicators and inflammatory factors between the two groups before treatment(P>0.05).After treatment,pulmonary function indicators,OI and PaCO_(2) in both groups were higher than those before treatment,which were higher in the observation group than in the control group;PaCO_(2) and inflammatory factors in both groups were lower than those before treatment,which were lower in the observation group than in the control group(P<0.05).The total incidence rate of adverse reactions was 7.14%in the observation group,which was lower than 23.81%in the control group(P<0.05).Conclusion Non-invasive ventilator ventilation combined with acetylcysteine solution inhalation has a significant clinical efficacy in the treatment of elderly patients with respiratory failure and hypercapnia.It can effectively improve the pulmonary function and blood gas indicators,and inhibit the occurrence of inflammatory reactions,and it is safe and reliable.