同步间歇指令联合无创通气治疗COPD呼吸衰竭的临床分析  

Clinical analysis of synchronous intermittent instruction combined with noninvasive ventilation in the treatment of COPD respiratory failure

作　　者：王亚丽 方天露 李玮娜 Wang Yali;Fang Tianlu;Li Weina(Department of Respiratory and Critical Care Medicine,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院呼吸与危重症医学科,100038

出　　处：《国际呼吸杂志》2020年第8期572-575,共4页International Journal of Respiration

基　　金：国家自然科学基金(81700007)。

摘　　要：目的研究同步间歇指令联合无创通气治疗慢性阻塞性肺疾病(COPD)呼吸衰竭的效果.方法选取2018年1月至2019年1月首都医科大学附属北京世纪坛院74例COPD呼吸衰竭患者,随机分为对照组(37例)与研究组(37例),对照组选用适应性支持通气治疗,研究组选用同步间歇指令联合无创通气治疗;比较2组治疗前后肺功能指标(每分钟最大通气量、用力肺活量、肺活量)、血清指标(免疫球蛋白G、免疫球蛋白M、免疫球蛋白A及C反应蛋白)与治疗后临床症状及体征消失时间.结果2组治疗前肺功能指标、血清指标水平差异无统计学意义(t=0.0249、0.3673、0.3032、0.0753、0.2341、0.1976、0.0264,P值均>0.05);与对照组比较,研究组治疗后免疫球蛋白G、每分钟最大通气量、用力肺活量及肺活量更高,免疫球蛋白M、免疫球蛋白A及C反应蛋白水平更低,哮鸣音、喘息、气促及咳嗽消失时间更短(t=5.4701、7.2335、7.1226、3.1561、3.9910、4.5664、10.9407、5.6494、5.3622、4.0511、4.1278,P值均<0.05).结论同步间歇指令联合无创通气治疗COPD呼吸衰竭的效果显著,可有效改善患者症状及体征,维持血清指标正常水平,促进其肺功能快速恢复,值得推广应用.Objective To study the effect of synchronous intermittent instruction combined with noninvasive ventilation in the treatment of chronic obstructive pulmonary disease(COPD)respiratory failure.Methods From January 2018 to January 2019,74 patients with COPD respiratory failure were selected from Beijing Shijitan Hospital affiliated to Capital Medical University were randomly divided into a control group(37 cases)and a study group(37 cases).Lung function indexes(maximum volume per minute,vital capacity per minute,vital capacity per minute)and serum indexes[immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin A(IgA)and C-reactive protein(CRP)]before and after treatment in the two groups were compared with the time of disappearance of clinical symptoms and signs after treatment.Results There was no significant difference in lung function index and serum index between the two groups before treatment(t=0.0249,0.3673,0.3032,0.0753,0.2341,0.1976,0.0264).Compared with control group,the team after treatment of IgG,the chase volume per minute,forced vital capacity and vital capacity is higher,IgM,IgA and CRP levels are lower,wheezing sound,breathing,shortness of breath and cough disappeared time shorter(t=5.4701,7.2335,7.1226,3.1561,3.9910,4.5664,10.9407,5.6494,5.3622,4.0511,4.1278,all P<0.05).Conclusions Synchronous intermittent instruction combined with non-invasive ventilation has a significant effect on the treatment of COPD respiratory failure,which can effectively improve the symptoms and signs of patients,maintain the normal level of serum indicators,and promote the rapid recovery of lung function,which is worthy of promotion and application.

关 键 词：肺疾病 慢性阻塞性 呼吸功能不全 同步间歇指令 无创通气 

分 类 号：R563[医药卫生—呼吸系统]