无创呼吸机治疗慢性阻塞性肺疾病合并高碳酸血症的效果及并发症分析

Analysis of the Effectiveness and Complications of Non-Invasive Ventilation in the Treatment of COPD Complicated with Respiratory Failure

目的:回顾性探究无创呼吸机在慢性阻塞性肺疾病(COPD)合并高碳酸血症应用疗效及对并发症的影响。方法:选择2023年4月~2024年3月医院收治COPD合并高碳酸血症患者80例,根据患者治疗方式分组,采用对症治疗方案40例,为对照组,采用对症治疗方案+无创呼吸机40例,为观察组,观察肺通换气功能、血气指标及并发症。结果:治疗前COPD合并呼吸衰竭患者肺通换气功能指标相似性高,治疗后第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC指标上升,前后对比有统计学差异(P<0.05);观察组FEV1、FVC、FEV1/FVC高于对照组,有统计学差异(P<0.05);治疗前COPD合并高碳酸血症患者血气指标相似性高,治疗后pH、SaO_(2)、PaO_(2)指标上升,PaCO_(2)指标下降,前后对比有统计学差异(P<0.05);观察组pH、SaO_(2)、PaO_(2)指标高于对照组(P<0.05),PaCO_(2)指标低于对照组,有显著统计学差异(P<0.01);对照组治疗期间继发重症肺炎2例,发生率5.0%,观察组治疗期间继发呼吸机相关性肺炎1例,发生率2.50%,两组比较无意义(P>0.05)。结论:无创呼吸机可有效改善COPD合并高碳酸血症患者肺通换气指标,近期疗效显著。

Objective:To review the effect of non-invasive ventilator on chronic obstructive pulmonary disease(COPD)complicated with hypercapnia and its effect on complications.Methods:From April 2023 to March 2024,80 patients with COPD combined with hypercapnia were divided into groups according to their treatment methods.40 patients were treated with symptomatic treatment plan as the reference group,and 40 patients were treated with symptomatic treatment plan plus non-invasive ventilator as the observation group.Pulmonary ventilation function,blood gas index and complications were observed.Results:The pulmonary ventilation function indexes of COPD patients with respiratory failure were similar before treatment,and the indexes of FEV1,FVC and FEV1/FVC increased after treatment,compared with before and after treatment(P<0.05).The indexes of FEV1,FVC and FEV1/FVC in the observation group were higher than those in the reference group(P<0.05),with statistical difference;The blood gas indexes of COPD patients with hypercapnia were similar before treatment,while pH,SaO_(2) and PaO_(2) indexes increased and PaCO_(2) indexes decreased after treatment(P<0.05).The pH,SaO_(2) and PaO_(2) indexes in the observation group were higher than those in the reference group(P<0.05),and the PaCO_(2) indexes were lower than those in the reference group(P<0.01),with statistically significant differences.During the treatment period,there were 2 cases of secondary severe pneumonia in the control group,with an incidence rate of 5.0%.In the observation group,there was 1 case of secondary ventilator-associated pneumonia during the treatment period,with an incidence rate of 2.50%.There was no significant difference between the two groups(P>0.05).Conclusion:Non-invasive ventilator can effectively improve pulmonary ventilation index in COPD patients with hypercapnia,and the short-term effect is significant.