支气管镜联合无创通气治疗慢性阻塞性肺疾病急性发作合并呼吸衰竭的临床疗效观察  

Clinical applications of bronchoscopy combined with noninvasive ventilation in acute onset of chronic obstructive pulmonary disease with respiratory failure

作　　者：崔卫正[1] 刘爽[1] 李冰[1] 陈巧英[1] 赵京梅[1] 李国翔[1] 王永红[1] 赵慧英[1] 

机构地区：[1]邯郸市中心医院呼吸内科,河北邯郸056001

出　　处：《临床和实验医学杂志》2016年第22期2241-2243,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨支气管镜联合无创通气在慢性阻塞性肺疾病急性发作合并呼吸衰竭的患者中的应用效果。方法选取2015年2月至2016年2月接受治疗的慢性阻塞性肺病急性发作合并呼吸衰竭的患者80例,按照随机数字表的方法,随机地分为观察组(n=40)和对照组(n=40),对观察组的患者采取在常规治疗基础上给予支气管镜联合无创呼吸机进行正压通气的治疗方法,对照组在常规治疗的基础上给予无创呼吸机正压通气治疗,比较两组患者的无创通气时间、住院时间,比较两组患者的有创机械通气发生率、病死率,比较两组患者治疗前后的氧分压(Pa O_2)、二氧化碳分压(Pa CO_2)和p H。结果观察组患者的无创通气时间和住院时间显著短于对照组患者(P<0.05),观察组患者的有创机械通气发生率和病死率显著低于对照组(P<0.05),治疗前两组患者的Pa O_2、Pa CO_2、p H差异无统计学意义(P>0.05)。治疗后,观察组患者的Pa O_2、Pa CO_2、p H显著优于对照组(P<0.05)。结论支气管镜联合无创正压通气治疗能够有效改善慢阻肺急性发作合并呼吸衰竭患者血气指示,降低病死率,促进患者康复,值得推广应用。Objective To discuss the clinical applications of bronchoscopy combined with noninvasive ventilation in acute onset of chronic obstructive pulmonary disease （COPD） with respiratory failure. Methods 80 cases of patients from February 2015 to February 2016 for treatment of acute attack of chronic obstructive pulmonary disease （COPD） with respiratory failure, according to random number table method, were randomly divided into observation group （ n = 40） and control group （ n = 40）. The observation group of patients performed bronchoscopy combined with noninvasive ventilation therapy, and tile patients in the control group performed noninvasive ventilator positive pressure ventilation therapy. The noninvasive breathing time, length of hospital stay, invasive mechanical ventilation rate, case fatality rate, before and after treatment of oxygen partial pressure （ PaO2 ）, CO2 partial pressure （ PaCO2 ） and pH were compared . Results The noninvasive breathing time and hospitalization time of observation group were significantly shorter than those of the control group patients （ P 〈 0. 05 ）. The invasive mechanical ventilation rate and case fatality rate of observation group were significantly lower than those of control group （ P 〈 0. 05 ）. Before treatment PaO2 , PaCO2 , pH differences of the two groups had no statistical significance （ P 〉 0.05 ）. After treatment, PaO2 , PaCO2 , pH value of the observation group were significantly better than those of control group （ P 〈 0.05 ）. Conclusion For chronic obstructive pulmonary disease in patients with acute attack of combination of respiratory failure treated by bronchoscopy combined with noninvasive positive pressure ventilation therapy can effectively reduce the mortality of patients, improve the patient＇s blood gas, promote patients recovery. Therefore, it is worthy of popularization and application.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 支气管镜 无创正压通气 

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