异丙托溴铵结合无创呼吸机治疗COPD合并呼吸衰竭的临床疗效  

Clinical effect of ipratropium bromide combined with noninvasive ventilator in the treatment of COPD complicated with respiratory failure

作　　者：刘湘陵 陈琼[1] LIU Xiangling;CHEN Qiong(Changsha Central Hospital Affiliated to Nanhua University,Changsha 410004,China)

机构地区：[1]南华大学附属长沙中心医院,长沙市410004

出　　处：《临床合理用药杂志》2023年第15期8-11,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察异丙托溴铵结合无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床疗效。方法 选取2020年1月—2021年12月南华大学附属长沙中心医院收治的72例COPD合并呼吸衰竭患者,根据治疗方法分为对照组和观察组,各36例。对照组采用无创呼吸机进行通气治疗,观察组在对照组基础上联合异丙托溴铵气雾剂治疗,2组均连续治疗1周。比较2组临床疗效,治疗1周后血气分析指标、肺功能指标、炎性因子及不良反应发生率。结果 观察组治疗总有效率为94.44%,高于对照组的77.78%(χ^(2)=4.181,P=0.041)。治疗1周后,观察组动脉血氧分压(PaO_(2))、pH值、血氧饱和度(SaO_(2))、用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC高于对照组,动脉血二氧化碳分压(PaCO_(2))及血清白介素-4(IL-4)、白介素-8(IL-8)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.01)。观察组不良反应总发生率为8.33%,低于对照组的27.78%(χ^(2)=4.600,P=0.032)。结论 COPD合并呼吸衰竭患者采用异丙托溴铵结合无创呼吸机治疗的效果较佳,可更有效地改善患者的血气指标,提升肺功能,减轻炎性反应,且安全性较高。Objective To observe the clinical effect of ipratropium bromide combined with noninvasive ventilator in the treatment of COPD complicated with respiratory failure.Methods A total of 72 cases of COPD complicated with respiratory failure patients were selected from January 2020 to December 2021 in Changsha Central Hospital Affiliated to Nanhua University,and they were divided into the control group and the observation group,36 cases in each group.Patients of the control group were treated with noninvasive ventilator for ventilation,and patients of the observation group were treated with ipratropium bromide based on the control group.Both groups were treated for 1 week.Clinical effect,blood gas analysis indexes,pulmonary function indexes and inflammatory factors after 1 week of treatment,incidence of adverse reactions were compared between the two groups.Results Total effective rate of the observation group was 94.44%,which was higher than 77.78%of the control group(χ^(2)=4.181,P=0.041).PaO_(2),pH value,SaO_(2),FVC,FEV_(1),FEV_(1)/FVC after 1 week of treatment of the observation group were higher than those of the control group,PaCO_(2) and serum levels of IL-4,IL-8,CRP,TNF-αwere lower than those of the control group(P<0.01).Incidence of adverse reactions of the observation group was 8.33%,which was lower than 27.78%of the control group(χ^(2)=4.600,P=0.032).Conclusion For COPD complicated with respiratory failure patients,ipratropium bromide combined with noninvasive ventilator have better effect,it can more effectively improve blood gas indexes of patients,promote pulmonary function,reduce inflammatory reactions,and with higher safety.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 异丙托溴铵 无创呼吸机 肺功能 治疗效果 

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