复方异丙托溴铵对慢性阻塞性肺疾病合并呼吸衰竭通气患者的影响

Effect of Compound Ipratropium Bromide on Patients With Chronic Obstructive Pulmonary Disease and Respiratory Failure Undergoing Ventilation

目的研讨复方异丙托溴铵在无创通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者中的辅助效果及对肺功能的影响。方法选取2021年5月—2022年11月福建省立金山医院收治的82例慢性阻塞性肺疾病合并呼吸衰竭患者,经随机数字表法完成病例分组,每组41例。对照组予以双水平正压通气(bilateral positive pressure ventilation,BiPAP)无创通气治疗,观察组基于对照组治疗条件辅用复方异丙托溴铵治疗,比较两组的临床疗效、治疗前后动脉血气指标、肺功能、血清炎性指标以及呼吸机相关性肺炎发生情况。结果观察组总有效率(95.12%)高于对照组(78.05%)(P<0.05)。治疗后,观察组动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、血氧饱和度(oxyhemoglobin saturation,SaO_(2))检测值高于对照组,二氧化碳分压(partial pressure of carbon dioxide,PaCO_(2))检测值低于对照组(P<0.05)。治疗后,观察组3项肺功能指标[第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)及二者比值(FEV1/FVC)]检测值均高于对照组(P<0.05)。治疗后,观察组2项血清学指标[降钙素原(procalcitonin,PCT)与白细胞介素-6(interleukin-6,IL-6)]值均低于对照组(P<0.05)。观察组发生呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)的患者占比(4.88%)低于对照组(19.51%)(P<0.05)。结论复方异丙托溴铵能够辅助提升慢性阻塞性肺疾病合并呼吸衰竭患者的无创通气治疗效果,减轻机体炎性反应,减少VAP发生,促进患者动脉血气及肺功能恢复。

Objective To investigate the auxiliary effect of compound ipratropium bromide on noninvasive ventilation in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure and its impact on lung function.Methods A total of 82 patients with chronic obstructive pulmonary disease(COPD) complicated with respiratory failure who were admitted to Fujian Provincial Jinshan Hospital from May 2021 to November 2022 were selected and divided into groups using a random number table method,with 41 cases in each group.The control group was treated with bilateral positive pressure ventilation(BiPAP) non-invasive ventilation,while the observation group was treated with compound ipratropium bromide based on the treatment conditions of the control group.The clinical efficacy,arterial blood gas indicators,pulmonary function,serum inflammatory indicators,and incidence of ventilator-associated pneumonia between the two groups before and after treatment were compared.Results The total effective rate in the observation group(95.12%) was higher than that in the control group(78.05%)(P<0.05).After treatment,arterial partial pressure of oxygen(PaO_2) and oxyhemoglobin saturation(SaO_2) of the observation group were higher than those of the control group,partial pressure of carbon dioxide(PaCO_2)was lower(P<0.05).After treatment,the three lung function indexes [forced expiratory volume in one second(FEV1),forced vital capacity(FVC) and the ratio(FEV1/FVC)] were higher than those of control group(P<0.05).After treatment,the two serum indexes [procalcitonin(PCT) and interleukin-6(IL-6)]in the observation group were lower than those in the control group(P<0.05).The proportion of patients with ventilatorassociated pneumonia(VAP) in the observation group(4.88%)was lower than that in the control group(19.51%)(P<0.05).Conclusion Compound ipratropium bromide can assist in enhancing the efficacy of noninvasive ventilation in patients with chronic obstructive pulmonary disease(COPD) combined with respiratory failure,reducing inflammatory reactions,reducing the incidence of VAP,and promoting the recovery of arterial blood gas and pulmonary function in patients.