肺康复联合无创通气治疗慢性阻塞性肺疾病合并呼吸衰竭临床效果观察

Clinical observation of lung rehabilitation combined with non-invasive ventilation in the treatment of chronic obstructive pulmonary disease with respiratory failure

目的探讨肺康复联合无创通气治疗对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者临床疗效、肺功能及血气分析的影响。方法我院2020年3月至2023年4月收治的COPD合并呼吸衰竭151例,根据治疗方案不同分为对照组(无创通气治疗)74例和观察组(肺康复+无创通气治疗)77例。对比两组临床疗效、肺功能[第1秒用力呼气容积(FEV1)、最大呼气流量(PEF)、用力肺活量(FVC)]、血气分析[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、治疗情况。结果观察组临床总有效率高于对照组(P<0.05)。治疗28 d后,观察组肺功能各指标水平均高于对照组,血气分析指标改善程度均优于对照组(P<0.05)。两组治疗后30 d院内死亡率比较差异无统计学意义(P>0.05)。观察组治疗后ICU住院时间、气管插管率低于对照组(P<0.05)。结论对COPD合并呼吸衰竭患者采用肺康复联合无创通气治疗治疗疗效更佳,可有效改善COPD合并呼吸衰竭患者的肺功能、血气分析指标。

Objective To investigate the effects of lung rehabilitation combined with non-invasive ventilation on clinical efficacy,lung function and blood gas analysis in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods One hundred and fifty-one patients with COPD combined with respiratory failure admitted to our hospital from March 2020 to April 2023 were selected.The patients were divided into a control group(n=74)and an observation group(n=77)according to different treatment plans.The control group was treated with non-invasive ventilation therapy and the observation group was treated with pulmonary rehabilitation+non-invasive ventilation therapy.The clinical efficacy,pulmonary function such as forced expiratory volume in the first second(FEV1),maximum expiratory flow(PEF)and forced vital capacity(FVC),blood gas analysis such as partial pressure of arterial oxygen(PaO_(2))and partial pressure of arterial carbon dioxide(PaCO_(2))and treatment situation were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).After 28 days of treatment,the lung function indexes and the improvement degree of blood gas analysis indexes of the observation group were higher than those of the control group(P<0.05).There was no difference in in-hospital mortality within 30 days after treatment between the two groups(P>0.05).The ICU stay time and tracheal intubation rate in the obser-vation group were shorter than those in the control group(P<0.05).Conclusions Pulmonary rehabilitation combined with non-invasive ventilation has a better therapeutic effect in the treatment of COPD patients with respiratory failure.It can effectively improve the pulmonary function and blood gas analysis indexes of COPD patients with respiratory failure.