无创正压通气在COPD合并呼吸衰竭患者中的疗效及对炎症因子的影响研究  

Noninvasive positive pressure ventilation for patients with COPD complicating respiratory failure and its effect on inflammatory factors

作　　者：高超[1] 李金博[2] 

机构地区：[1]山东省高唐县人民医院急诊科,252800 [2]山东省高唐县人民医院普外科,252800

出　　处：《国际医药卫生导报》2018年第2期188-192,共5页International Medicine and Health Guidance News

摘　　要：目的探讨分析无创正压通气在COPD合并呼吸衰竭患者中的疗效及对炎症因子的影响。方法选取2016年1月至2017年4月期间本院收治的COPD合并呼吸衰竭患者80例，随机分为对照组和研究组，对照组采用常规治疗，研究组在常规治疗的基础上联合无创正压通气治疗；对比分析治疗的效果以及对炎症因子的影响。结果通过联合使用无创正压通气治疗，研究组患者的HR恢复到正常值（88．7±5．5）次／min，动脉血pH从（7．25±0．03）升高到（7．40±0．04），Pa02从（51．19±4．9）mmHg上升到（74．81±6．2）mmHg，PaC02从（63．74．4-2．3）mmHg下降到（54．15±1．6）mmHg，差异均有统计学意义（P值分别为0．028、0．043、0．039、0．027）；研究组治疗后炎症因子中TNF-α、IL～113、IL-8、IL-10的水平分另U为（0．11±0．01）μg／L、（34．76±4．26）ng／L、（52．19±5．98）ng／L、（8．42±0．94）ng／L，对照组治疗后的炎症因子TNF-α、IL-1β、IL-8、IL-10水平分别为（0．29±0．03）μg／L、（78．75±8．35）ng／L、（71．37±8．35）ng／L、（17．49±1．81）ng／L，研究组炎症因子水平明显低于对照组（尸值分别为0．042、0．021、0．037、0．040）；研究组治疗总有效率为95．0％，对照组治疗总有效率为75．O％，研究组治疗总有效率明显高于对照组（P=0．039）。结论针对COPD合并呼吸衰竭患者的治疗，使用常规治疗联合无创正压通气具有良好的效果，使患者的血气指标和心率呼吸等恢复正常，改善了炎症因子的水平，并且减少了并发症的发生，值得推广和应用。Objective To investigate the efficacy of noninvasive positive pressure ventilation for patients with chronic obstructive pulmonary disease （COPD） complicating respiratory failure and its influence on inflammatory factors. Methods 80 patients with COPD complicating respiratory failure treated at our hospital from January, 2016 to April, 2017 were selected and were randomly divided into a control group and a study group. The control group were routinely treated; in addition, the study group were treated by noninvasive positive pressure ventilation. The treatment effects and influence on inflammatory factors were analyzed and compared. Results After the treatment, the HR was （ 88.7±5.5 ） beats/min, the arterial blood pH increased from （ 7.25±0.03 ） to （ 7.40±0.04 ） , the PaO2 increased from （ 51.19±4.9 ） mmHg to （ 74.81±6.2 ） mmHg, and the PaCO2 decreased from （ 63.74±2.3 ） mmHg to （ 54.15±1.6 ） mmHg in the study group, with statistical differences （P=0.028, 0.043, 0.039, 0.027）. After the treatment, the levels ofTNF-α, IL- 1β, IL-8, and IL-10 were （ 0.11±0.01 ） ttg/L, （ 34.76±4.26 ） ng/L, （ 52.19±5.98 ） ng/L, （ 8.42±0.94 ） ng/L in the study group and were （ 0.29±0.03 ） μg/L, （ 78.75±8.35 ） ng/L, （ 71.37±8.35 ） ng/L, and （ 17.49±1.81 ） ng/L in the control group （P=-0.042, 0.021, 0.037, 0.040）. The total effective rate was 95.0% in the study group and 75.0% in the control group （P=0.039）. Conclusions Routine treatment combining noninvasive positive pressure ventilation for patients with COPD complicating respiratory failure is effective and can recover the patients＇ blood gas indicators and heart rate and respiratory, improve the levels of inflammatory factors, and decrease the incidence of complications, so it is worth being clinically generalized.

关 键 词：无创正压通气 COPD 呼吸衰竭 炎症因子 疗效 

分 类 号：R563[医药卫生—呼吸系统]