纤维支气管镜联合无创通气治疗COPD并Ⅱ型呼吸衰竭  

Bronchoscopy Joint Noninvasive Ventilation in Treatment of COPD with Type II Respiratory Failure

作　　者：陈婷[1] 曾红[1] 周宏伟[1] 石代辉[1] 范中惠[1] 

机构地区：[1]钦州市第二人民医院呼吸内科,广西钦州535000

出　　处：《医学综述》2013年第20期3819-3821,共3页Medical Recapitulate

摘　　要：目的探讨纤维支气管镜联合无创正压通气(NPPV)治疗慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭的临床疗效。方法选取2010年1月至2012年10月在钦州市第二人民医院呼吸内科就诊的COPD并Ⅱ型呼吸衰竭的患者50例,按随机数字法分为观察组和对照组,对照组给予常规内科加NPPV治疗;观察组在对照组的基础上加用纤维支气管镜治疗。比较两组的治疗效果、有创通气率、总住院时间及住院费用。结果治疗后观察组和对照的总有效率分别为23/25及17/25,观察组的治疗效果显著优于对照组(Z=2.123,P<0.05);有创通气率观察组显著低于对照组(8%vs48%,Z=3.149,P<0.05);总住院时间及住院费用观察组少于对照组,比较差异具有统计学意义(t=10.49,15.623,P<0.05)。结论纤维支气管镜联合NPPV能有效地纠正COPD并Ⅱ呼吸衰竭,减少有创通气的概率,缩短住院时间,降低住院费用,值得临床推广。Objective To explore bronchoscopy lavage joint noninvasive positive pressure ventilation （NPPV） on treatment of chronic obstructive pulmonary disease （ COPD ） with type II respiratory failure. Methods Fifty COPD patients with infection-induced type II respiratory failure were selected from the Sec- ond People＇s＇Hospital of Qinzhou City during January 2010 and October 2012, and randomly divided into treatment group and control group, the control group received conventional medical intensive plus NPPV, while the treatment group was given additional fiber bronchoscopy on the basis of the control group. After treatment, the treatment effectiveness, invasive ventilation rate, total length of hospital stay, and cost of hospi- talization were compared. Results The total effective rate of the treatment group and the control were 23/25 and 17/25, the therapeutic effect of the treatment group was significantly better than the control group （Z = 2. 123 ,P 〈0.05 ） ,invasive ventilation rate of the treatment group was lower than the control group（ 8% vs 48 %, Z = 3.149, P 〈 0.05 ） ,total length of stay and hospital costs of the treatment group were less than the control group（t =10.49,15.623,P〈0.05）. Conclusion Bronchoscopy combined with NPPV can effec- tively redress COPD with type II respiratory failure, with reduced invasive ventilation rate, shorter hospital stays, and decreased hospitalization costs, which is worth of popularization in clinical.

关 键 词：纤维支气管镜 无创通气 COPD Ⅱ型呼吸衰竭 

分 类 号：R563.8[医药卫生—呼吸系统]