无创正压通气治疗重症慢性阻塞性肺疾病合并呼吸衰竭的效果

Effect of Noninvasive Positive Pressure Ventilation on Severe Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

目的:分析无创正压通气治疗重症慢性阻塞性肺疾病(简称慢阻肺)合并呼吸衰竭的效果。方法:选取2021年1月—2022年12月印江土家族苗族自治县人民医院收治的重症慢阻肺合并呼吸衰竭患者124例为观察对象,依据随机数字表法分为对照组和观察组,各62例。对照组予以常规治疗,观察组在对照组基础上联合无创正压通气治疗。比较两组患者肺功能与血气分析指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气流量峰值(PEF)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SpO_(2))]、炎性因子、症状改善时间及不良反应发生率。结果:治疗后,观察组FEV1、FVC、PEF、PaO_(2)、SpO_(2)水平高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.05);观察组肿瘤坏死因子-α、白细胞介素-8、白细胞介素-6水平低于对照组,差异有统计学意义(P<0.001);观察组咳嗽改善时间、咳痰改善时间、呼吸困难改善时间均短于对照组,差异有统计学意义(P<0.001);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:重症慢阻肺合并呼吸衰竭患者行常规治疗联合无创正压通气治疗效果较好,可促进肺功能、血气分析指标、临床症状及相关指标改善,且不会明显增加不良反应,安全性较高。

Objective:To analyze the effect of non-invasive positive pressure ventilation in the treatment of severe chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:A total of 124 patients with severe COPD combined with respiratory failure admitted to the Yinjiang Tujia and Miao Autonomous County People's Hospital from January 2021 to December 2022 were selected as observation objects,and were divided into control group and observation group according to random number table method,with 62 cases in each group.The control group was given routine treatment,and the observation group was combined with non-invasive positive pressure ventilation on the basis of the control group.The pulmonary function and blood gas analysis indexes[forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),peak expiratory flow(PEF),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),blood oxygen saturation(SpO_(2))],inflammatory factors,symptom improvement time and incidence of adverse reactions were compared between the two groups.Results:After treatment,the levels of FEV1,FVC,PEF,PaO_(2) and SpO_(2) in the observation group were higher than those in the control group,and the level of PaCO_(2) was lower than that in the control group,with statistical significance(P<0.05);The levels of tumor necrosis factor-α,interleukin-8 and interleukin-6 in observation group were lower than those in control group,the difference was statistically significant(P<0.001);The improvement time of cough,expectoration and dyspnea in observation group was shorter than that in control group,and the difference was statistically significant(P<0.001);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:In patients with severe COPD complicated with respiratory failure,conventional treatment combined with non-invasive positive pressure ventilation is effective and can promote the improvement of lung function,blood gas analysis indicators,clinical symptoms and related indicators,and will not significantly increase adverse reactions,with high safety.