舒利迭与无创通气联用对老年COPD合并呼吸衰竭患者的疗效观察  

Observation on effectiveness of seretide combined with noninvasive positive pressure ventilation for elderly patients with chronic obstructive pulmonary disease and respiratory failure

作　　者：郑权[1] 唐菊梅[1] 黄勤[1] 代光明[1] 汪洪[1] 

机构地区：[1]四川省遂宁市第一人民医院呼吸内科,629000

出　　处：《疑难病杂志》2015年第1期36-38,41,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨舒利迭与无创通气(NPPV)联用对老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭(RF)患者的价值。方法 2012年4月—2014年3月住院治疗的老年COPD合并RF患者120例,随机分为2组,每组60例。对照组接受基础治疗加NPPV,而观察组在对照组的基础上予以舒利迭,疗程均6个月。治疗前后测量患者的肺功能指标:一秒用力呼气容积(FEV_1)、用力肺活量(FVC)和最大呼气流速(PEF),动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)及呼吸困难评分,记录2组患者的不良反应。结果治疗前,2组患者的FEV_1、FVC、PEF、PaO_2、PaCO_2和呼吸困难评分相比,差异无统计学意义(P>0.05);治疗后,观察组FEV_1、FVC和PEF分别为(1.36±0.38)L、(2.19±0.67)L和(3.22±1.27)L/s,好于对照组的(1.16±0.22)L、(2.02±0.43)L和(2.73±1.01)L/s(P<0.05);治疗后,观察组PaO_2、PaCO_2和呼吸困难评分改善程度明显优于对照组(P<0.05),不良反应率为10.0%(6/60)高于对照组的6.7%(4/60),但差异无统计学意义(P>0.05)。结论舒利迭联合NPPV治疗能有效改善老年COPD合并RF患者的肺功能和动脉血气,有助于患者的康复,是安全有效的治疗手段。Objective To investigate the effect of seretide and non-invasive ventilation（NPPV） on senile chronic obstructive pulmonary disease（COPD） complicated with respiratory failure（RF）.Methods There were 120 elderly patients with COPD enrolled since April 2012 to March 2014 were selected.All patients were randomized divided into two groups,60 eases in the observation group and 60 cases in the control group.The control group received basic treatment and given NPPV treatment on this basis,the observation group received Seretide treatment on the basis of the control group,both groups were treated for six months.Lung function including forced expiraton volume in one second（FEV,）.forced vital capacity（FVC）and peak expiratory（low（PEF） in patients before and alter treatment were measured,as well as arterial oxygen partial pressure（PaO2）,arterial carbon dioxide partial pressure（PaCO2）.and dyspnea score were detected,adverse events were recorded in the two groups of patients.Results Before treatment,the FEV1,FVC,PEF,PaO2,PaCO2 and dyspnea scores in 2groups revealed no significant difference（P〈0.05）;after the treatment,the FEV1,FVC and PEF[（1.36 ±0.38） L,（2.19 ±0.67） L and（3.22 ± 1.27） L/s,respectively]in the observation group were better than those in the control group[（1.16 ±0.22） L,（2.02±0.43） L and（2.73±1.01） L/s]（P〈0.05）;after treatment.the PaO2,PaCO2 and the dyspnea score in the observation group were improved significantly better than those in the control group（P〈0.05）,the adverse reaction rate was 10.0%（6/60）,which was higher than thai of control group6.7%（4/60）,but the difference was not statistically significant（P〉0.05）.Conclusion Seretide combined with NPPV therapy can effectively improve the pulmonary function and arterial blood gas in the elderly patients with COPD complicated with RF,which is contributing to the patients recovery,it is a safe and effective treatment method.

关 键 词：舒利迭 无创正压通气 慢性阻塞性肺疾病 呼吸衰竭 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]