长期 NIPPV 治疗稳定期 COPD合并慢性呼衰的疗效  

Complicated associated Curative efficacy of long-term NIPPV on COPD with chronic respiratory failure

作　　者：郭俊华[1] 冯志军[1] 王红燕[1] 黄志昂[1] 路武杰[1] 李荟萍 

机构地区：[1]河南大学第一附属医院呼吸内科,开封475001

出　　处：《中国实用医刊》2015年第22期74-75,共2页Chinese Journal of Practical Medicine

基　　金：院内科研项目（201238）

摘　　要：目的：探讨长期无创正压通气（ NIPPV）治疗重度稳定期COPD合并慢性呼吸衰竭患者的临床疗效。方法选择2011年1月至2013年1月处于稳定期的重度COPD患者60例，随机分为NIPPV组和对照组，每组30例，对比两组患者在随访1年内COPD急性发作次数及住院天数；比较两组治疗后动脉血气分析pH值、PaO2、PaCO2及肺功能；比较两组患者治疗前后圣乔治问卷评分（ SGRQ评分）、呼吸困难评分（ MMRC评分）、6 min步行试验（6-MWT）的变化。结果 NIPPV组患者在随访1年内急性发作次数和住院天数分别为（1.0±1.0）次、（14.0±4.0）d，对照组为（5.0±1.0）次、（26.0±7.0）d，NIPPV组少于对照组，差异有统计学意义（P＜0.01）；两组患者治疗后动脉血气分析显示，pH值及PaO2均较治疗前明显提高，PaCO2较治疗前下降，但NIPPV组优于对照组，差异有统计学意义（P＜0.01）；肺功能检测显示，两组患者FEV1％均较治疗前提高，NIPPV组效果更优，差异有统计学意义（P＜0.05）；两组患者治疗1年后生活质量有所改善，其中两组SGRQ评分及MMRC呼吸困难评分均较治疗前下降，6-MWT较前提高，但NIPPV组明显优于对照组，差异具有统计学意义（ P＜0.01）。结论重度稳定期COPD合并慢性呼衰患者长期使用NIPPV治疗，效果确切，可以有效改善患者高碳酸血症，提高运动耐力，改善生活质量。Objective To investigate the clinical effect of long-term non-invasive positive pressure ventilation （ NIPPV） on stable chronic obstructive pulmonary disease （ COPD） complicated with chronic respiratory failure （ CRF） . Methods From January 2011 to January 2013, 60 patients with severe COPD at stable stages complicated with CRF were randomly divided into two groups （the NIPPV group and the control group）.The NIPPV group （n=30） were treated with NIPPV based on conventional therapy, while the control group （ n=30） were treated with conventional therapy.One year after treatment, PaO2, PaCO2, 6-minutes walk test （6-MWT） and St George’s respiratory questionnaire（SGRQ） were detected in the two groups.Results After 1 year, the frequency of acute exacerbations of COPD and hospital stay days were significantly decreased in the NIPPV group than that in the control group.The value of arterial blood gas improved va-riously than before,but the NIPPV group was better than the control group.The lung function analysis showed FEV1%in-crease in two groups, but the NIPPV group was better than the control group.After 1 year treatment the lives of patients in two groups get better, the value of SGRQ, MMRC decreased than before and 6-MWT improved, the NIPPV group was bet-ter than the control group, the differences was statistically significant （P〈0.01）.Conclusions For patients with severe COPD at stable stage complicated with CRF, NIPPV can significantly improve the quality of life and reduce hypercapnia.

关 键 词：稳定期COPD 呼吸衰竭 无创正压通气 

分 类 号：R563[医药卫生—呼吸系统]