粗针联合基础治疗改善慢性阻塞性肺疾病急性发作呼吸机脱机困难临床研究  

Clinical Study of Thick Needle Combined with Basic Treatment Improving Difficulty in Weaning Ventilator of AECOPD

作　　者：孙丽华[1] 邓冬 贾丽阳 杨晔颖[1] 彭伟 方邦江[1] SUN Lihua;DENG Dong;JIA Liyang;YANG Yeying;PENG Wei;FANG Bangjiang(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《针灸临床杂志》2021年第3期40-43,共4页Journal of Clinical Acupuncture and Moxibustion

基　　金：上海市卫计委中医特色诊疗技术提升项目,编号:zyjx-2017001;上海市卫计委重要薄弱学科建设计划项目,编号:2016ZB0207。

摘　　要：目的:观察粗针联合基础治疗改善慢性阻塞性肺疾病急性发作(AECOPD)病患临床上无创或有创呼吸机脱机困难的效果。方法:纳入2017年6月—2019年3月于龙华医院急诊科住院的AECOPD重症患者,选择其中60例作为研究对象,根据随机数字表法分为两组,即对照组30例与治疗组30例。对照组予西医常规基础治疗,治疗组予粗针联合西医常规基础治疗,分析比较两组患者的呼吸机脱机时间、脱机成功率、呼吸功能客观评价指标及死亡率。结果:治疗后治疗组呼吸机脱机时间(7.91±3.71)d较对照组(10.83±3.04)d明显缩短(P<0.05);治疗组脱机成功率(66.7%,20/30),较对照组(40.0%,12/30),明显提高,差异具有统计学意义(P<0.05);治疗组死亡率(20%,6/30),较对照组(46.7%,14/30),明显降低,差异有统计学意义(P<0.05);经过治疗,两组在呼吸机脱机前分别与治疗前相比能够降低二氧化碳分压(PaCO2),提高氧分压(PaO2),改善氧合指数(OI),差异有统计学意义(P<0.05);而且相关呼吸功能的这3项指标,在脱机前治疗组优于对照组,差异具有统计学意义(P<0.05)。结论:粗针联合西医基础治疗无创或有创呼吸机脱机困难的AECOPD患者疗效肯定,较单纯使用西医基础治疗效果更佳,值得临床推广。Objective:To observe the effect of thick needle combined with basic therapy on improving the difficulty of non-invasive or invasive ventilator weaning in patients with acute episode of chronic obstructive pulmonary disease(AECOPD).Methods:60 patients with AECOPD were randomly divided into the control group(n=30)and the treatment group(n=30).The control group was given routine basic treatment of western medicine;on which basis,the treatment group was also treated with thick needle.The weaning time of ventilator,weaning success rate,objective evaluation index of respiratory function and mortality were analyzed and compared between the two groups.Results:The ventilator weaning time was(7.91±3.71)d in the treatment group,which was significantly shorter(10.83±3.04)d in the control group(P<0.05).The success rate of weaning was 66.7%(20/30)in the treatment group,which was significantly higher than 40%(12/30)in the control group(P<0.05).The mortality of the treatment group was 20%(6/30),which was significantly lower than 46.7%(14/30)in the control group(P<0.05).PaCO2 was lowered,PaO2 was increased and OI was improved after the treatment compared to those before the treatment in the two groups(P<0.05);of which the improvements in the treatment group were more significant(P<0.05).Conclusion:Thick needle combined with basic treatment of western medicine is effective in improving the difficulty of non-invasive or invasive ventilator weaning in patients with AECOPD,which is better than single application of the basic treatment of western medicine.

关 键 词：粗针 慢性阻塞性肺疾病急性发作 呼吸机脱机困难 

分 类 号：R246.1[医药卫生—针灸推拿学]