平均容量保证压力支持通气在急诊COPD伴CO_(2)潴留患者中的应用

Application of AVAPS Non-Invasive Ventilation Mode in the Treatment of COPD with CO_(2) Retention in Emergency

目的 探究平均容量保证压力支持通气(average volume assured pressure support,AVAPS)在急诊慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴CO_(2)潴留中的应用价值。方法 回顾性选取2020年4月—2023年5月永嘉县人民医院急诊收治的86例COPD合并CO_(2)潴留患者为研究对象,按不同治疗方法将患者分为两组,各43例。对照组接受同步间歇强制通气,研究组接受AVAPS。对比两组患者血气分析、呼吸机通气参数指标水平。结果 两组通气24 h的血氧分压、血氧饱和度水平均高于通气前,二氧化碳分压水平均低于通气前,且研究组的血氧分压[(89.36±2.17)mmHg]、血氧饱和度[(96.42±2.69)%]水平高于对照组[(76.42±2.31)mmHg、(87.52±2.37)%],二氧化碳分压[(53.42±3.43)mmHg]水平低于对照组[(67.83±2.76)mmHg],差异有统计学意义(t=26.773、16.279、21.463,P均<0.05)。通气24 h,研究组的潮气量高于对照组,通气量、气道峰压水平均低于对照组,差异有统计学意义(P均<0.05)。结论 在临床急诊COPD伴CO_(2)潴留患者中应用AVAPS有利于改善患者的血气指标水平和通气参数指标,从而调节患者的预后情况。

Objective To explore the application value of average volume assured pressure support(AVAPS) in emergency chronic obstructive pulmonary disease(COPD) with CO_(2) retention.Methods A total of 86 patients with COPD complicated with CO_(2) retention admitted to the Department of Emergency of Yongjia County People's Hospital from April 2020 to May 2023 were retrospectively selected as the research objects.The patients were divided into two groups according to different treatment methods,with 43 cases in each group.The control group received synchronous intermittent forced ventilation,and the study group received AVAPS.The levels of blood gas analysis and ventilator ventilation parameters were compared between the two groups.Results Ventilation for 24 h,two groups of partial pressure of blood oxygen,blood oxygen saturation levels are higher than ventilation,partial pressure of carbon dioxide level was lower than ventilation before,the levels of blood oxygen partial pressure [(89.36±2.17) mmHg] and blood oxygen saturation [(96.42±2.69) %] in the study group were higher than those in the control group [(76.42±2.31) mmHg,(87.52±2.37) %],the level of carbon dioxide partial pressure in the observation group was [(53.42±3.43) mmHg],which was lower than [(67.83±2.76) mmHg] in the control group,and the differences were statistically significant(t=26.773,16.279,21.463,all P<0.05).After 24 hours of ventilation,the tidal volume of the study group was higher than that of the control group,and the ventilation volume and peak airway pressure were lower than those of the control group,and the differences were statistically significant(all P<0.05).Conclusion The application of AVAPS in clinical emergency COPD patients with CO_(2) retention is beneficial to improve the blood gas index level and ventilation parameter index of patients,so as to regulate the prognosis of patients.