家庭应用无创机械通气对COPD患者肺功能及医疗费用的影响  

Effects of Family Noninvasive Mechanical Ventilation in Patients with COPD on Lung Function and Medical Expenses

作　　者：陈宏[1] 尚愚 于方飞[1] 周丹[1] 吕福祯[1] 肖金玲[1] 

机构地区：[1]哈尔滨医科大学附属第二医院呼吸科,黑龙江哈尔滨150086 [2]哈尔滨市第一人民医院,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2013年第12期2325-2327,2331,共4页Progress in Modern Biomedicine

基　　金：黑龙江省科技公关项目(GC06C415)

摘　　要：目的:在COPD急性发作期无创机械通气治疗已经被临床医生重视并广泛应用于临床治疗。但对于家庭应用无创机械通气治疗缓解期的患者是否获益,目前尚无明确结论。本试验旨在探讨家庭应用无创机械通气对COPD患者生活质量、运动耐量、肺功能及医疗费用的影响。方法:随机观察103例慢性阻塞性肺疾病急性发作合并Ⅱ型呼吸衰竭患者,于医院应用无创辅助通气治疗缓解后出院。其中39例继续应用无创机械通气治疗(治疗组),其余64停止无创机械通气治疗(对照组),观察6个月,比较家庭应用无创机械通气治疗后生活质量、运动耐量、肺功能变化、血气分析、心率、呼吸频率及急性发作的间隔期、医疗费用状况。结果:治疗组较对照组生活质量、运动耐量明显改善(P<0.05),肺功能下降明显减慢(P<0.05),平均医疗费用明显减少(P<0.05)。结论:家庭应用无创机械通气能够延缓COPD患者肺功能下降速度,减少医疗费用近万元,延长急性加重间隔时间6个月以上,减少住院次数,提高生存质量。Objective： To measure the application of non-invasive mechanical ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease has received the attention of clinicians and widely used in clinical treatment, However, whether the benefit, that from home noninvasive mechanical ventilation treatment applied in remission of patients, is no clear conclusion currently. The purpose of this experiment is to explore the impact on quality of life, exercise tolerance, lung function and medical expenses in the patients of COPD who use the home noninvasive mechanical ventilation. Methods： 103 patients suffering acute exacerbation of chronic obstructive pulmonary disease combined with type Ⅱrespiratory failure were randomly observed, who applied noninvasive assisted ventilation treatment at hospital, and discharged after remission. Of which 39 cases continues to applications noninvasive mechanical ventilation treatment （the treatment group）, the remaining 64 cases stopped （ the control group）, By observing six months, the quality of life, exercise tolerance and tung function changes, blood gas analysis, heart rate, respiratory rate, acute exacerbation intervals and medical expenses were compared in home noninvasive mechanical ventilation. Results： Compared with the control group, the quality of life and exercise tolerance were improved significantly in the treatment group （P 〈0.05）, lung function declined slowly significantly （P〈0.05）, average medical costs decreased significantly （P〈0.05）. Conclusion： Home noninvasive mechanical ventilation can slow the rate of decline of lung function, reduce medical costs, and improve quality of life in patients with COPD.

关 键 词：慢性阻塞性肺疾病 无创机械通气 肺功能 

分 类 号：R563[医药卫生—呼吸系统]