不同给氧方式对慢性阻塞性肺病合并呼吸衰竭患者预后的影响研究  

Different Ways of Oxygen Effect on the Prognosis of Patients with Respiratory Failure of Chronic Obstructive Pulmonary Disease

作　　者：聂蓉晖[1] 吕秀花[1] 王兆丽[1] 

机构地区：[1]泰山医学院附属泰山医院老年三科,山东泰安271000

出　　处：《泰山医学院学报》2015年第4期400-404,共5页Journal of Taishan Medical College

摘　　要：目的观察无创正压通气在治疗急性加重期的慢性阻塞性肺疾病合并有II型呼吸衰竭的治疗效果。方法选择我院收治的60例COPD合并Ⅱ型呼吸衰竭病患者作为研究对象,随机分为对照组和观察组,每组各30例,两组病患均给予常规治疗,观察组在给予常规治疗的同时加用无创正压通气的治疗,运用急性生理学及慢性健康状况系统评分Ⅱ(APACHEⅡ评分)为标准,观察两组患者在治疗前后的心率、呼吸频率、血气分析和临床指标变化。结果观察组与对照组患者在治疗后APACHEII评分高于治疗前APACHEII评分,差异有统计学意义(P<0.05)。观察组与对照组患者在治疗后CPIS评分低于治疗前CPIS评分,差异有统计学意义(P<0.05)。经过治疗后,观察组患者的APACHEII评分高于对照组患者的APACHEII评分,差异有统计学意义(P<0.05)。经过治疗后,观察组患者的CPIS评分低对照组患者的CPIS评分,差异有统计学意义(P<0.05)。观察组的患者在住院日、病死率与对照组相比较显示出明显地减少和降低,观察组与对照组相比较差异有统计学意义(P<0.05)。结论运用无创正压通气治疗急性加重期的慢性阻塞性肺疾病合并有II型呼吸衰竭可以提高治疗疗效,降低并发症发生率、死亡率。Objective： to observe noninvasive positive pressure ventilation with type II respiratory failure with treatment effect in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods： In our hospital 60 cases of COPD with type II respiratory failure patients were treated as the research object,and were randomly divided into control group and observation group,with 30 cases in each group,two groups of patients were given conventional treatment,in the observation group,given conventional treatment plus non- invasive positive pressure ventilation in the treatment. Application of acute physiology and chronic health score（ APACHE score） as the standard,in the two groups were observed before and after treatment of heart rate,respiratory rate,blood gas analysis and the changes of clinical parameters. Results： the observation group and the control group in the APACHEII score after treatment was higher than before treatment APACHEII score,the difference was statistically significant（ P〈0. 05）. The observation group and the control group of patients after treatment CPIS score lower than before treatment CPIS score,the difference was statistically significant（ P〈0. 05）. After treatment,the APACHEII score of the observation group was higher than that in the control group of patients with APACHEII score,the difference was statistically significant（ P〈0. 05）. After treatment,CPIS scores of the observation group and control group of patients with low CPIS score,the difference was statistically significant（ P〈0. 05）. The observation group of patients in hospitalization,mortality rate compared with the control group showed significantly reduced,with statistical significance difference in observation group compared with the control group（ P〈0. 05）. Conclusion： Combined use of noninvasive positive pressure ventilation in treatment of acute exacerbation of chronic obstructive pulmonary disease with type II respiratory failure can improve the curative effect,reduce the in

关 键 词：无创机械通气 COPD 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]