无创正压通气联合纤维支气管镜吸痰治疗慢性阻塞性肺疾病并呼吸衰竭的临床效果

Clinical effect of non-invasive positive pressure ventilation combined with fiberoptic bronchoscopy sputum aspiration for chronic obstructive pulmonary disease complicated with respiratory failure

目的探讨无创正压通气(NIPPV)联合纤维支气管镜吸痰治疗慢性阻塞性肺疾病(COPD)并呼吸衰竭的临床效果。方法选取重庆市第九人民医院2015—2017年收治的COPD并呼吸衰竭患者55例,随机分为对照组28例与观察组27例。对照组患者给予NIPPV治疗,观察组患者在对照组基础上加用纤维支气管镜吸痰治疗。比较两组患者临床疗效、有创机械通气发生率、病死率、住院时间及治疗前后动脉血气指标〔pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)〕。结果观察组治疗有效率高于对照组,有创机械通气发生率、病死率低于对照组,住院时间短于对照组(P<0.05)。治疗前两组pH值、PaO2和PaCO2比较,差异无统计学意义(P>0.05);治疗后观察组pH值、PaO2高于对照组,PaCO2低于对照组(P<0.05)。结论 NIPPV联合纤维支气管镜吸痰治疗COPD并呼吸衰竭的临床效果确切,可有效改善患者临床症状,提高呼吸功能。

Objective To investigate the clinical effect of non-invasive positive pressure ventilation(NIPPV combined with fiberoptic bronchoscopy sputum aspiration for chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods A total of 55 cases of patients with COPD complicated with respiratory failure were selected from2015 to 2017 in Chongqing Ninth People’s Hospital,which were randomly divided into control group(n=28)and observation group(n=27).The control group was treated with NIPPV,and the observation group was treated with fiberoptic bronchoscope based on the control group.Clinical effect,incidence of invasive mechanical ventilation,fatality rate,length of stay,arterial blood gas index(pH,PaO2,PaCO2)before and after treatment were compared between the two groups.Results The observation group of effective rate of treatment was higher than control group,incidence rate of invasive mechanical ventilation,fatality rate were lower than control group,length of stay was shorter than control group(P<0.05).There was no significant difference in pH,PaO2 or PaCO2 between the two groups before treatment(P>0.05).After treatment,the observation group of the pH,PaO2 were higher than control group,PaCO2 was lower than control group(P<0.05).Conclusion NIPPV combined with fiberoptic bronchoscopy sputum aspiration have an exact clinical effect for COPD complicated with respiratory failure,it can effectively improve the clinical symptoms of the patient and improve the breathing function.