无创正压通气(NPPV)联合呋塞米雾化吸入对AECOPD伴呼吸衰竭的临床观察

Clinical observation of Noninvasive positive pressure ventilation(NPPV) combined with furosemide Inhaled in AECOPD complicated with respiratory failure

目的:探讨无创正压通气(NPPV)联合呋塞米雾化吸入对慢性阻塞性肺疾病加重期(AECOPD)合并Ⅱ型呼吸衰竭伴有痰液黏稠的患者的临床疗效。方法:收治慢性阻塞性肺疾病急性加重期患者60例,随机分为对照组和治疗组各30例。对照组给予急性加重期的治疗,并在治疗的同时给予无创正压通气;治疗组在对照组治疗的基础上,给予呋塞米氧化雾化吸入。记录每组治疗前后血气分析的数值(pH值、PaO2、PaCO2)。对照组按常规治疗及应用无创正压通气后24小时,记录血气分析的数值;治疗组按常规及应用无创正压通气并给予呋塞米氧化雾化吸入治疗后24小时,记录血气分析的数值;进一步比较治疗组和对照组治疗前后血pH值、PaO2、PaCO2的变化值。结果:治疗组和对照组治疗前后血pH值、PaO2、PCO2变化值的比较差异认为差异有统计学意义(P<0.01)。结论:在AECOPD合并Ⅱ型呼吸衰竭伴有痰液黏稠的患者,应用无创正压通气联合呋塞米氧化雾化吸入治疗较单一应用无创正压通气治疗的患者,更能快速地改善其缺氧和二氧化碳潴留的情况。

Objective:To explore the clinical curative effect of Noninvasive positive pressure ventilation(NPPV)combined with furosemide Inhaled in AECOPD complicated with respiratory failure with sticky sputum.Methods:We selected 60 patients with acute exacerbations of chronic obstructive pulmonary disease,these patients were randomly divided into control group and treatment group of each 30 people.The control group received the treatment of an exacerbation,and at the same time was given noninvasive positive pressure ventilation;The treatment group was given furosemide oxidation atomization inhalation therapy based on the control group.The figure of blood gas analysis(pH,PaO2,PaCO2)of the two groups before and after treatment were recorded.In the control group treated with the treatment of an exacerbation and noninvasive positive pressure ventilation,24 hours after treatment,the figure of blood gas analysis were recorded.In the treatment group treated with conventional treatment and noninvasive positive pressure ventilation and furosemide oxidation atomization inhalation therapy,24 hours after treatment,the figure of blood gas analysis were recorded.We made a further comparison of the treatment group and the control group in the changes of the blood pH,PaO2,PaCO2 value before and after treatment.Results:In the treatment group and the control group,there were significant difference of blood pH,PaO2 and PaCO2before and after treatment(P<0.01).Conclusion:In patients with AECOPD complicated with type Ⅱ respiratory failure with thick sputum,compared with a single application of noninvasive positive pressure ventilation,application of noninvasive positive pressure ventilation combined with furosemide oxidation atomization inhalation treatment,can more rapidly improve the hypoxia and carbon dioxide retention of patients.