不同时间采用NPPV治疗COPD合并呼吸衰竭的疗效观察  

Observation of therapeutic effects of non-invasive positive pressure ventilation at different time on COPD combined with respiratory failure

作　　者：李艳[1] 

机构地区：[1]四川省成都市第七人民医院呼吸内科,成都610041

出　　处：《西南国防医药》2014年第5期486-489,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨不同时间采用无创正压通气（NPPV）治疗慢性阻塞性肺病急性加重期（AECOPD）合并呼吸衰竭的临床疗效。方法选择2011年1月～2013年11月在我院住院的AECOPD合并呼吸衰竭患者168例,根据NPPV治疗时间的早晚分为早期治疗组69例和延迟治疗组56例,另外43例未采用NPPV的设为对照组。治疗3 d后观察3组患者的呼吸频率、心率、pH、PaCO2、PaO2的变化,同时比较3组的住院时间、气管插管率和病死率。结果与治疗前比较,3组的呼吸频率、心率、pH、PaCO2、PaO2均有所改善（P〈0.05）;3组之间比较,NPPV早期治疗组的上述指标改善最明显,延迟治疗组次之,对照组最小（P〈0.01）。NPPV早期治疗组的住院时间、气管插管率及病死率均比对照组短或低（P〈0.05或P〈0.01）;早期治疗组与延迟治疗组比较差异无统计学意义。结论 NPPV治疗AECOPD合并呼吸衰竭,能纠正缺氧,改善CO2潴留,缩短住院时间,降低气管插管率和病死率,并且早期治疗效果更好,值得临床推广应用。Objective To investigate the clinical effect of non-invasive positive pressure ventilation（ NPPV） at different time on patients with acute exacerbation of chronic obstructive pulmonary diseases（ AECOPD） combined with respiratory failure. Methods168 patients with AECOPD combined with respiratory failure were included in the study from January,2011 to November,2013 in our hospital. According to the time of giving NPPV,125 patients were divided into the early intervention treatment group（ 69 cases） and delayed treatment group（ 56 cases）. The other 43 patients without giving NPPV were set to control group. Respiratory rate（ RR）,heart rate（ HR） and arterial blood gas of three groups were detected after 3 days of the treatment. At the same time,hospitalization time,endotracheal intubation rate and death rate were observed. Results The respiration rate,heart rate,arterial blood pH,arterial partial pressure of carbon dioxide（ PaCO2）,and arterial partial pressure of oxygen（ PaO2） were significantly improved in 3 groups after treatment. Above indexes in the early intervention treatment group were improved the most obviously,the delayed treated group took the second place,and the control group were improved the least; there were significant differences among 3 groups（ P〈0. 01）. The hospital time,endotracheal intubation rate,death rate was significantly different between the early intervention treatment group and the control group,however there were no significantly difference of above indexes between the early intervention treatment group and delayed treatment group. Conclusions NPPV can effectively improve the clinical symptoms and arterial blood gas of patients with AECOPD combined with respiratory failure,shorten hospital time,decrease the need for endotracheal intubation and death rate. The earlier NPPV is given,the better the curative effect is.

关 键 词：慢性阻塞性肺病 呼吸衰竭 正压通气 早期 疗效 

分 类 号：R563.8[医药卫生—呼吸系统]