抗感染药物联合BiPAP无创通气治疗老年呼吸衰竭的疗效观察

Efficacy observation of anti-infective drugs combined with BiPAP non-invasive ventilation in elderly patients with respiratory failure

目的浅析老年呼吸衰竭采取抗感染药物联合双水平气道正压通气呼吸机(BiPAP)无创通气治疗的临床价值。方法68例老年呼吸衰竭患者,依据随机数字表法分为对照组与研究组,各34例,对照组接受常规抗感染药物,研究组接受抗感染药物联合BiPAP无创通气治疗。比较两组患者治疗前后的心率、呼吸频率、动脉血气指标[动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))]、肺功能指标[第1秒钟用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC]、不良反应发生情况。结果治疗1、2 d后,研究组患者心率分别为(97.42±7.62)、(85.13±4.91)次/min,呼吸频率分别为(21.72±6.50)、(20.05±4.13)次/min,均低于对照组的(101.58±9.34)、(99.72±7.68)、(26.97±5.87)、(24.97±4.25)次/min,差异有统计学意义(P<0.05)。治疗7 d后,研究组患者PaCO_(2)(44.08±2.67)mm Hg(1 mm Hg=0.133 kPa)低于对照组的(50.27±3.16)mm Hg,PaO_(2)(79.14±5.91)mm Hg、SaO_(2)(91.98±8.67)%均高于对照组的(67.15±5.12)mm Hg、(83.41±8.52)%,差异有统计学意义(P<0.05)。治疗7 d,研究组患者FEV1(2.04±0.72)L、FVC(3.11±0.41)L、FEV1/FVC(72.47±9.27)%均高于对照组的(1.68±0.61)L、(2.67±0.48)L、(64.18±8.26)%,差异有统计学意义(P<0.05)。研究组不良反应发生率8.82%低于对照组的29.41%,差异有统计学意义(P<0.05)。结论老年呼吸衰竭患者给予抗感染药物联合BiPAP无创通气治疗具有积极意义,可有效改善患者的临床症状,提高氧合及肺功能,具有推广价值。

Objective To analyze the clinical value of anti-infective drugs combined with bi-level positive airway pressure(BiPAP)non-invasive ventilation in elderly patients with respiratory failure.Methods 68 elderly patients with respiratory failure were selected.According to random number table,patients were assigned to a control group and a study group,each with 34 cases.The control group received conventional anti-infective drugs,and the study group received anti-infective drugs combined with BiPAP non-invasive ventilation.Patients in both groups were compared in terms of heart rate,respiratory rate,arterial blood gas indexes[arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2),and blood oxygen saturation(SaO2)],pulmonary function indexes[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC]before and after treatment,and the occurrence of adverse reactions.Results After 1 and 2 d of treatment,the heart rate in the study group were(97.42±7.62)and(85.13±4.91)beats/min,and the respiratory rate were(21.72±6.50)and(20.05±4.13)times/min,which were lower than(101.58±9.34),(99.72±7.68)beats/min and(26.97±5.87),(24.97±4.25)times/min in the control group.The difference was statistically significant(P<0.05).After 7 d of treatment,PaCO2 was(44.08±2.67)mm Hg(1 mm Hg=0.133 kPa)in the study group,which was lower than(50.27±3.16)mm Hg in the control group;the study group had PaO2 of(79.14±5.91)mm Hg and SaO2 of(91.98±8.67)%,which were higher than(67.15±5.12)mm Hg and(83.41±8.52)%in the control group;the difference was statistically significant(P<0.05).After 7 d of treatment,the study group had FEV1 of(2.04±0.72)L,FVC of(3.11±0.41)L,FEV1/FVC of(72.47±9.27)%,which were higher than(1.68±0.61)L,(2.67±0.48)L,(64.18±8.26)%in the control group.The difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was 8.82%,which was lower than 29.41%in the control group,and the difference was statistically significant(P<0.05).Conclusion The anti-infective drugs combined with BiPAP non-invasive ventilation has positive significance in elderly patients with respiratory failure,which can effectively improve the clinical symptoms of patients,improve the oxygenation indexes and pulmonary function,and has popularization value.