无创机械通气联合噻托溴铵吸入对慢阻肺合并Ⅱ型呼衰患者的临床研究

Clinical study of non-invasive mechanical ventilation combined with tiotropium bromide inhalation in patients with COPD complicated with type Ⅱ respiratory failure

目的研究无创机械通气和噻托溴铵联合治疗对慢阻肺合并Ⅱ型呼衰患者的临床效果。方法以周口市第一人民医院2019年1月—2021年1月入院符合纳入标准的100例患者为研究对象,两组均采用噻托溴铵粉剂吸入治疗,实验组使用无创机械通气辅助治疗。比较两组治疗前后肺功能、炎症因子、血气指标、mMRC、CAT量表评分和临床疗效。结果治疗后实验组通气指标(FEV_(1)、FVC和FEV_(1)/FVC)与对照组相比明显提高(P<0.05);治疗后实验组血气分析指标PaO_(2)和PaCO_(2)与对照组相比趋于正常水平(P<0.05);治疗后实验组炎症因子数值(TNF-α、IL-6、IL-8)显著优于对照组(P<0.05);治疗后实验组mMRC、CAT评估与对照组相比均降低(P<0.05);实验组治疗总有效率较对照组高8%。结论无创机械通气联合噻托溴铵对慢阻肺合并Ⅱ型呼衰的治疗,能够改善肺功能,降低炎症反应,恢复呼吸酸碱平衡,提高患者自主呼吸能力,对治疗慢性呼吸疾病中具有借鉴价值。

Objective To study the clinical effects of non-invasive mechanical ventilation and tiotropium bromide combined therapy in patients with COPD complicated with type Ⅱ respiratory failure.Methods A total of 100 patients with COPD complicated with type Ⅱ respiratory failure admitted to our hospital from January 2019 to January 2021 were randomly divided into control group and experimental group,50 patients in each group were treated with tiotropium powder inhalation,and the experimental group was treated with non-invasive mechanical ventilation.Ventilation function,inflammatory factors,arterial partial pressure of oxygen and carbon dioxide,mMRC,CAT scale score and clinical efficacy were compared between the two groups before and after treatment.Results After treatment,ventilation indexes(FEV_(1),FVC and FEV_(1)/FVC)in the experimental group were significantly higher than those in the control group(P<0.05).After treatment,blood gas analysis indexes PaO_(2)and PaCO_(2)in the experimental group tended to normal levels compared with the control group(P<0.05).After treatment,inflammatory factors(TNF-α,IL-6,IL-8)in the experimental group were significantly better than those of the control group(P<0.05).After treatment,mMRC and CAT scale scores in the experimental group were lower than those of the control group(P<0.05).The total effective rate of experimental group was 90%,higher than that of control group 8%.Conclusion Non-invasive mechanical ventilation combined with tiotropium bromide in the treatment of COPD combined with type Ⅱ respiratory failure can improve lung function,reduce inflammatory response,restore the acid-base balance of respiration,improve patients’ability to breathe,which has reference value in the treatment of chronic respiratory diseases.