双水平无创正压通气联合硫酸沙丁胺醇治疗慢性阻塞性肺疾病急性加重期伴呼吸衰竭的效果分析

Efficacy of bi-level noninvasive positive pressure ventilation combined with salbutamol sulfate on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure

目的分析双水平无创正压通气联合硫酸沙丁胺醇治疗慢性阻塞性肺疾病急性加重期伴呼吸衰竭的临床疗效。方法抽取焦作市人民医院2020年2月至2022年5月收治的慢性阻塞性肺疾病急性加重期伴呼吸衰竭患者130例,按照随机数字表法分为对照组与观察组,每组65例。对照组采取常规治疗联合硫酸沙丁胺醇治疗,观察组在对照组的治疗基础上联合双水平无创正压通气,两组均治疗2周。比较两组治疗前及治疗2周后血气指标[酸碱度(pH)、氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、二氧化碳分压(PaCO_(2))]、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流速(PEF)]。结果治疗2周后,两组pH、SaO_(2)、PaO_(2)水平均高于治疗前,PaCO_(2)水平低于治疗前(P<0.05),且观察组PaO_(2)、SaO_(2)、pH水平高于对照组,PaCO_(2)水平低于对照组(P<0.05)。治疗2周后,两组FEV1、FVC、PEF水平均高于治疗前,且观察组FEV1、FVC、PEF水平均高于对照组(P均<0.05)。结论针对慢性阻塞性肺疾病急性加重期伴呼吸衰竭患者,采取双水平无创正压通气联合硫酸沙丁胺醇治疗的效果明显,有助于提升患者肺功能指标水平。

Objective To analyze the clinical efficacy of bi-level noninvasive positive pressure ventilation combined with salbutamol sulfate in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)with respiratory failure.Methods A total of 130 patients with acute exacerbation of COPD complicated by respiratory failure treated in Jiaozuo People’s Hospital from February 2020 to May 2022 were selected,and they were divided into control group and observation group by random number table method,with 65 cases in each group.The control group was treated by conventional treatment combined with salbutamol sulfate,while the observation group was treated by bi-level noninvasive positive pressure ventilation based on the treatment of the control group.Both groups were treated for two weeks.Before treatment and after 2 weeks of treatment,the levels of blood gas indexes including potential of hydrogen(pH),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))and partial pressure of carbon dioxide(PaCO_(2)),and pulmonary function indexes including forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and maximum expiratory flow rate(PEF)of the two groups were detected and compared.Results After 2 weeks of treatment,the levels of pH,SaO_(2) and PaO_(2) of the two groups were higher than those before treatment,and the level of PaCO_(2) of the two groups were lower than those before treatment(P<0.05).After 2 weeks of treatment,the levels of PaO_(2),SaO_(2) and pH in the observation group were higher than those in the control group,and PaCO_(2) was significantly lower than that in the control group(P<0.05).After 2 weeks of treatment,the FEV1,FVC and PEF of the two groups were higher than those before treatment,moreover,levels of FEV1,FVC and PEF of the observation group were higher than those of the control group(all P<0.05).Conclusions In clinical,bi-level noninvasive positive pressure ventilation combined with salbutamol sulfate has a great effect on acute exacerbation of COPD with respiratory failure,and it is conductive to promoting the lung function index level.