无创正压机械通气治疗AECOPD合并呼吸衰竭患者的疗效  

Efficacy of non-invasive positive pressure ventilation in the treatment of AECOPD patients with respiratory failure

作　　者：张贤 任丹虹 ZHANG Xian;REN Danhong(Intensive Care Unit,Hangzhou Chest Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属杭州市胸科医院ICU,浙江杭州310003

出　　处：《中国现代医生》2022年第17期98-101,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY598)。

摘　　要：目的 探讨无创正压机械通气(NPPV)治疗急性加重期慢性阻塞性肺疾病(AECOPD)合并呼吸衰竭患者的临床效果。方法 选取2018年6月~2020年11月浙江大学医学院附属杭州市胸科医院收治的AECOPD合并呼吸衰竭患者120例,随机分为对照组和治疗组,每组各60例;对照组给予常规治疗,而治疗组在此基础上给予NPPV治疗;比较两组治疗后的生命体征指标(呼吸频率、心率、平均动脉压)、血气指标(pH值、PaO_(2)、PaCO_(2))、肺功能指标(FEV_(1)、FVC、FEV_(1)/FVC)、总有效率、不良反应及住院时间等指标。结果 治疗后,治疗组的呼吸频率、心率、平均动脉压等均低于对照组(均P<0.05);治疗组的pH值、PaO_(2)水平均高于对照组(均P<0.05),而治疗组的PaCO_(2)水平则低于对照组(P<0.05);治疗组的FEV_(1)、FVC、FEV_(1)/FVC等指标水平均大于对照组(均P<0.05);治疗组的总有效率为93.33%,高于对照组的73.33%(P<0.05);治疗组的住院时间明显短于对照组(P<0.05);两组间的不良反应发生率比较,差异无统计学意义(P>0.05)。结论 AECOPD合并呼吸衰竭患者经过NPPV治疗后,可调节患者的生命体征,提高血氧水平和肺功能,改善治疗效果和预后。Objective To investigate the clinical effect of non-invasive positive pressure ventilation(NPPV) in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with respiratory failure. Methods A total of 120 patients with AECOPD complicated with respiratory failure admitted to Hangzhou Chest Hospital, Zhejiang University School of Medicine, from June 2018 to November 2020 were randomly divided into control group(n=60) and treatment group(n=60). The control group was treated with routine treatment. The treatment group was given NPPV treatment on this basis. Vital signs(respiratory rate, heart rate, mean arterial pressure), blood gas(pH value, PaO_(2), PaCO_(2)), pulmonary function(FEV_(1), FVC, FEV_(1)/FVC), overall response rate, adverse reactions, and length of hospital stay were compared between the two groups after treatment. Results After treatment,the respiratory rate, heart rate, and mean arterial pressure in the treatment group were lower than those in the control group(all P<0.05). The pH value and PaO_(2)level in the treatment group were higher than those in the control group(all P<0.05), while the PaCO_(2)level in the treatment group was lower than that in the control group(P<0.05). The FEV_(1),FVC, and FEV_(1)/FVC in the treatment group were more significant than those in the control group(all P <0.05). The overall response rate in the treatment group was 93.33%, higher than 73.33% in the control group(P<0.05). The length of hospital stay in the treatment group was significantly longer than that in the control group(P<0.05). However, there was no statistical difference in the incidence rate of adverse reactions between the two groups(P>0.05). Conclusion NPPV can regulate the vital signs, improve the level and pulmonary function, and improve the therapeutic effect and prognosis of AECOPD patients with respiratory failure.

关 键 词：加重期慢性阻塞性肺疾病 呼吸衰竭 无创正压机械通气 疗效 

分 类 号：R563.9[医药卫生—呼吸系统]