体外膈肌起搏器治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者的疗效研究

Therapeutic effect of extracorporeal diaphragm pacemaker on patients with acute exacerbation of chronic obstructive pulmonary disease complicated with TypeⅡrespiratory failure

目的 研究体外膈肌起搏器(EDP)治疗慢性阻塞性肺疾病(COPD)急性加重期合并Ⅱ型呼吸衰竭患者的效果。方法 选取的100例COPD急性加重期合并Ⅱ型呼吸衰竭患者均为重庆三峡医药高等专科学校附属人民医院呼吸与危重症医学科2021年1月至2023年8月收治,按照随机数表法分为对照组和观察组,每组各50例。对照组采用常规治疗,观察组在对照组的基础上联合EDP治疗。比较两组治疗前后的改良呼吸困难指数(mMRC)、慢性阻塞性肺疾病评估测试(CAT)及Berg评分、动脉血二氧化碳分压(PCO_2)、动脉血氧分压(PO_2)、氢离子浓度指数(pH),两组的住院期间呼吸机使用时间、住院时间、住院费用以及最终疗效。结果 治疗后,观察组的疗效高于对照组(82.00%vs.64.00%),差异有统计学意义(P<0.05)。两组的mMRC、CAT、PCO_2随着治疗均降低,Berg评分、PO_2随着治疗均升高,且观察组的mMRC、CAT、PCO_2降低程度高于对照组,Berg评分、PO_2升高程度高于对照组,差异有统计学意义(P<0.05)。治疗前,两组的pH差异无统计学意义(P>0.05);治疗后,对照组的pH和治疗前比较,差异无统计学意义(P>0.05),观察组的pH降低,差异有统计学意义(P<0.05)。结论 EDP治疗在改善COPD急性加重期合并Ⅱ型呼吸衰竭患者的呼吸功能、健康损害程度和平衡能力方面具有显著优势,还能够有效缩短住院时间和降低住院费用,值得在临床上推广应用。

Objective To study the therapeutic effect of extracorporeal diaphragm pacemaker(EDP)on patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated with TypeⅡrespiratory failure.Methods A total of 100 patients with acute exacerbation of chronic obstructive pulmonary disease complicated with TypeⅡrespiratory failure were selected and treated in the Department of Respiratory and Critical Care Medicine,the People’Hospital Affiliated to Chongqing Three Gorges Medical College from January 2021 to August 2023.They were divided into a control group and an observation group of 50 cases each using a random number table method.The control group received routine treatment measures,while the observation group received combined treatment with an EDP on the basis of the control group.The modified medical research council(mMRC),COPD assessment test(CAT)and Berg score,partial pressure of carbon dioxide(PCO2),partial pressure of oxygen(PO2),potential of hydrogen(pH)the duration of ventilator use,hospitalization time,hospitalization costs and final curative effect were compared between the two groups before and after treatment.Results After treatment,the curative effect of observation group(82.00%vs.64.00%)was higher than that of control group,and the difference was statistically significant(P<0.05).The mMRC,CAT and PO2 of the two groups decreased with the treatment,while Berg score and PO2 increased with the treatment.The mMRC,CAT and PO2 of the observation group decreased more than those of the control group,while Berg score and PO2 increased more than those of the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in pH between the two groups(P>0.05).After treatment,there was no statistically significant difference in the pH of the control group compared with that before treatment(P>0.05),but the pH of the observation group decreased,with statistically significant difference(P<0.05).Conclusion EDP treatment has significant advantages in improving respiratory function,health damage,and balance ability in patients with acute exacerbation of COPD and TypeⅡrespiratory failure.It can also effectively shorten hospitalization time and reduce hospitalization costs,and is worth promoting and applying in clinical practice.