家庭无创正压通气对稳定期COPD合并Ⅱ型呼吸衰竭患者的疗效观察  

Clinical efficacy of home noninvasive positive pressure ventilation in the stable patients of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

作　　者：田银君[1] 刘前桂[1] 赵黎黎[1] 赵双燕[1] 张媛[1] 吴海玲[1] 胡晓凤[1] Tian Yinjun;Liu Qiajigui;Zhao Lili;Zhao Shuangyan;Zhang Yuan;Wu Hailing;Hu Xiaofeng(Department of Respiratory Rehabilitation,Beijing Geriatric Hospital,Beijing 100095,China)

机构地区：[1]北京老年医院呼吸康复科,100095

出　　处：《国际呼吸杂志》2020年第8期576-580,共5页International Journal of Respiration

摘　　要：目的观察家庭无创正压通气(HNPPV)治疗对稳定期慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者的疗效.方法选取稳定期COPD合并Ⅱ型呼吸衰竭患者60例,根据有无长期HNPPV通气分为观察组32例及对照组28例,2组患者均给予常规治疗,观察组在常规治疗的基础上加用HNPPV.2组患者入组前及治疗1年时均测定动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%pred)、FEV1/FVC、6分钟步行距离(6MWD),采用改良英国医学研究委员会呼吸困难量表(mMRC)进行呼吸困难评估,采用COPD评估测试(CAT)问卷进行症状评估.记录1年内因COPD急性加重的住院次数.结果观察组与对照组治疗后比较,PaO2显著升高(t=3.02,P<0.01),PaCO2显著降低(t=-9.52,P<0.01),FVC显著增高(t=2.5,P<0.05),6MWD显著增高(t=12.86,P<0.01),mMRC、CAT问卷、住院次数显著降低(t=-4.76、-2.14、-10.41,P值均<0.05).结论稳定期COPD合并Ⅱ型呼吸衰竭患者在一般治疗的基础上加用HNPPV,可以纠正低氧血症和CO2潴留,改善肺功能,提高运动耐量,减轻临床症状,减少住院次数.Objective To explore the clinical efficacy of home noninvasive positive pressure ventilation(HNPPV)in the stable patients of chronic obstructive pulmonary disease(COPD)complicated with type Ⅱ respiratory failure.Methods Sixty cases of patients with stable COPD complicated with type Ⅱ respiratory failure were divided into observation group of 32 cases and control group of 28 cases.Both groups were given routine treatment,the observation group were given long-term HNPPV on the basis of routine treatment.Then observed blood gas analysis,pulmonary function and dyspnea etc,before and after ventilator used in one year.Results After treatment for one year,arterial partial pressure of oxygen(Pa02),forced vital capacity(FVC)and six-minute walking distance(6MWD)were improved in observation group significantly than the control group(t=3.02,2.5,12.86,all P<10.05).Partial pressure of carbon dioxide in artery(PaCO2),Modified British medical research council(mMRC)breathlessness measurement,COPD assessment test(CAT)questionnaire and the number of hospitalization were decreased in observation group significantly than the control group(t=-9.52,-4.76,-2.14,-10.41,all P<10.05).Conclusions Stable patients of COPD complicated with type Ⅱ respiratory failure on the basis of routine treatment combined with HNPPV,can correct hypoxemia and CO2 retention,improve lung function,improve exercise tolerance,relieve the clinical symptoms,reduce the number of hospitalization.

关 键 词：肺疾病 慢性阻塞性 无创通气 

分 类 号：R563[医药卫生—呼吸系统]