无创正压通气联合氧气驱动雾化吸入对慢性阻塞性肺疾病并呼吸衰竭患者的影响  

Impact of Non-invasive Positive Pressure Ventilation Combined with Oxygen-driven Aerosol Inhalation in Treating COPD Patients Complicated with Respiratory Failure

作　　者：刘振国[1] 王顺达[2] 张红英[1] 卢晓娥[1] 宗媛[1] LIU Zhen-guo;WANG Shun-da;ZHANG Hong-ying;LU Xiao-e;ZONG Yuan(Department of Critical Care Medicine,Shaanxi Provincial People's Hospital,Shaanxi 710068,China;Department of Rehabilitation Medicine,Shaanxi Provincial People's Hospital,Shaanxi 710068,China)

机构地区：[1]陕西省人民医院重症医学科,陕西省西安市710068 [2]陕西省人民医院康复医学科,陕西省西安市710068

出　　处：《实用心脑肺血管病杂志》2018年第10期88-91,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨无创正压通气联合氧气驱动雾化吸入对慢性阻塞性肺疾病(COPD)并呼吸衰竭患者的影响。方法选取2014年9月—2017年10月陕西省人民医院收治的COPD并呼吸衰竭患者82例,根据治疗方式分为对照组与研究组,每组41例。在常规治疗基础上,对照组患者给予无创正压通气治疗,研究组患者在对照组基础上给予氧气驱动雾化吸入治疗;两组患者均连续治疗7 d。比较两组患者临床疗效,治疗前及治疗后7 d动脉血气分析指标、血清炎性因子水平,撤机成功率,治疗后28 d存活率,并观察两组患者治疗期间不良反应/并发症发生情况。结果(1)研究组患者临床疗效优于对照组(P<0.05)。(2)治疗前两组患者pH值、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)比较,差异无统计学意义(P>0.05);治疗后7 d研究组患者pH值、PaO2高于对照组,PaCO2低于对照组(P<0.05)。(3)治疗前两组患者血清C反应蛋白(CRP)、内毒素(LPS)、降钙素原(PCT)水平比较,差异无统计学意义(P>0.05);治疗后7 d研究组患者血清CRP、LPS、PCT水平低于对照组(P<0.05)。(4)研究组患者撤机成功率、治疗后28 d存活率高于对照组(P<0.05)。(5)治疗期间研究组患者不良反应/并发症发生率低于对照组(P<0.05)。结论无创正压通气联合氧气驱动雾化吸入能有效提高COPD并呼吸衰竭患者临床疗效,改善患者通气功能,降低血清炎性因子水平,提高撤机成功率及近期存活率,且安全性较高。Objective To investigate the impact of non-invasive positive pressure ventilation combined with oxygen-driven aerosol inhalation in treating COPD patients complicated with respiratory failure. Methods A total of 82 COPD patients complicated with respiratory failure were selected in Shaanxi Provincial People’s Hospital from September 2014 to October 2017,and they were divided into control group and study group according to therapeutic methods,each of 41 cases.Based on conventional treatment,patients in control group received non-invasive positive pressure ventilation,while patients in study group received non-invasive positive pressure ventilation combined with oxygen-driven aerosol inhalation;both groups continuously treated for 7 days. Clinical effect,arterial blood-gas analysis results and serum inflammatory cytokines levels before treatment and 7 days after treatment,success rate of ventilator weaning,survival rate 28 days after treatment,and incidence of adverse reactions/complications during treatment were compared between the two groups. Results(1)Clinical effect in study group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant differences of pH,PaCO2 or PaO2 was found between the two groups before treatment(P>0.05);7 days after treatment,pH and PaO2 in study group were statistically significantly higher than those in control group,while PaCO2 in study group was statistically significantly lower than that in control group(P<0.05).(3)No statistically significant differences of serum level of CRP,LPS or PCT was found between the two groups before treatment(P>0.05),while serum levels of CRP,LPS and PCT in study group were statistically significantly lower than those in control group 7 days after treatment(P<0.05).(4)Success rate of ventilator weaning and survival rate 28 days after treatment in study group were statistically significantly higher than those in control group(P<0.05).(5)Incidence of adverse reactions/complications in study group was statist

关 键 词：肺疾病 慢性阻塞性 呼吸功能不全 氧气驱动雾化吸入 无创正压通气 治疗结果 

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