支气管肺泡灌洗联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床研究  

Clinical research for chronic obstructive pulmonary disease patients with respiratory failure treated by bronchoalveolar lavage combined with non-invasive positive pressure ventilation

作　　者：吴金如[1] 曾宪升[1] 

机构地区：[1]湖北省襄阳市中心医院呼吸二科,湖北襄阳441021

出　　处：《实用临床医药杂志》2017年第12期25-28,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨支气管肺泡灌洗联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效。方法选择本科住院治疗的慢性阻塞性肺疾病合并呼吸衰竭的患者104例,按照治疗方法的不同随机分为对照组(常规治疗组)和观察组(BAL+NIPPV治疗组),观察记录2组患者治疗前、治疗后2 h、治疗后12 h以及治疗后24 h动脉血气分析,以及治疗期间2组患者的不良反应发生情况。结果 2组患者治疗后24 h,p H值均较治疗前显著提高(P<0.05),观察组p H值较对照组升高显著(P<0.05);2组患者治疗后各时间点p(CO_2)、p(O_2)与治疗前比较,p(CO_2)降低,p(O_2)升高,且观察组患者改善状况优于对照组(P<0.05);2组患者气管插管、腹胀和鼻面部压伤的不良反应发生率差异显著(P<0.05)。结论支气管肺泡灌洗联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭可显著提高患者p(O_2),降低p(CO_2),提高血p H值,有效改善患者的呼吸衰竭症状,纠正患者酸碱失衡,值得临床推广应用。Objective To investigate the clinical value of bronchoalveolar lavage （BAL） combined with noninvasive positive pressure ventilation （NIPPV） for chronic obstructive pulmonary disease patients with respiratory failure.Methods A total of 104 chronic obstructive pulmonary disease patients with respiratory failure in our hospital were randomly divided into control group （conventional treatment group） and observation group （BAL＋NIPPV treatment group）.Arterial blood gas values of two groups before and after the treatment, 2 hours, 12 hours and 24 hours after treatment were compared, and the incidence of adverse reactions of two groups during treatment was analyzed.Results The PH value was significantly increased at 24 h after treatment in both groups, the difference was statistically significant （P〈0.05）.Compared with treatment before, p（CO2） was significantly decreased, and p（O2） was increased obviously at each time point, and the improvement of observation group was better than the control group, the differences were statistically significant （P〈0.05）.The incidence of adverse reactions in tracheal intubation, abdominal distension and nasal and farcical bruise of two groups showed a significant difference in two groups（P〈0.05）.Conclusion BAL combined with NIPPV can significantly improve patients＆#39;＆#39;p（O2）, reduce p（CO2）, and improve blood PH value, effectively improve the patient＆#39;＆#39;s symptoms of respiratory failure, and correct the acid-base imbalance, so it worthy of clinical popularization and application.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 支气管肺泡灌洗 无创正压通气 

分 类 号：R473.5[医药卫生—护理学]