无创正压通气联合氧气驱动雾化吸入对COPD合并呼吸衰竭患者的有效性和安全性分析

Analysis of the Effectiveness and Safety of Non-invasive Positive Pressure Ventilation Combined with Oxygen-driven Nebulization in Patients with COPD Complicated by Respiratory Failure

目的探究无创正压通气(NPPV)联合氧气驱动雾化吸入对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者的有效性和安全性。方法选取2021年2月至2023年2月期间驻马店市中心医院收治的94例COPD合并呼吸衰竭患者,应用随机数表法将其分为对照组(n=47)及观察组(n=47),对照组接受NPPV治疗,观察组联合氧气驱动雾化吸入治疗,对比两组治疗有效率、血气指标、肺功能指标、炎症因子水平、圣乔治呼吸量表评分(SGRQ)。结果观察组治疗有效率高于对照组,差异具有统计学意义(P<0.05)。观察组PaO_(2)、pH水平高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义。观察组用力肺活量(FVC)、第一秒用力呼气容积(FEV_(1))、一秒钟用力呼气容积与用力肺活量的比值(FEV_(1)/FVC)水平高于对照组,差异具有统计学意义(P<0.05)。观察组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平低于对照组,差异具有统计学意义(P<0.05)。观察组各维度呼吸问题评分低于对照组,差异具有统计学意义(P<0.05)。结论COPD合并呼吸衰竭患者采用NPPV联合氧气驱动雾化吸入治疗效果显著,可改善血气指标,改善肺功能,降低炎症因子水平,可改善呼吸衰竭患者呼吸相关问题。

Objective To explore the effectiveness and safety of Non-invasive positive pressure ventilation(NPPV)combined with oxygen-driven nebulization in patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure.Methods 94 patients with COPD complicated by respiratory failure admitted to Zhoukou Central Hospital from February 2021 to February 2023 were selected.According to the random number table method,they were divided into the control group(n=47,treated with NPPV)and the observation group(n=47,treated with NPPV combined with oxygen-driven nebulization).The treatment effectiveness,blood gas indicators,lung function indicators,inflammation factor levels,and St.George’s Respiratory Questionnaire(SGRQ)scores of the two groups were compared.Results The treatment effectiveness rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The PaO_(2)and pH levels of the observation group were higher than those of the control group,and the PaCO_(2)level was lower than that of the control group,and the differences were statistically significant.The forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1)),and the ratio of forced expiratory volume in one second to forced vital capacity(FEV_(1)/FVC)of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-8(IL-8)levels of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The scores of each dimension of respiratory problems in the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The use of NPPV combined with oxygen-driven nebulization in patients with COPD complicated by respiratory failure has significant effects,can improve blood gas indicators,improve lung function,reduce inflammation factor levels,and improve respiratory-related problems in patients with respiratory failure.