无创正压机械通气对慢阻肺合并呼吸衰竭患者动脉血气分析的影响  

Effect of Non-invasive Positive Pressure Mechanical Ventilation on Arterial Blood Gas Analysis in Patients with COPD Complicated with Respiratory Failure

作　　者：李芳 张伟华[1] Li Fang;Zhang Wei-hua(Shangqiu First People's Hospital,Shangqiu 476100,Henan Province,China)

机构地区：[1]商丘市第一人民医院,河南商丘476100

出　　处：《罕少疾病杂志》2023年第11期47-48,63,共3页Journal of Rare and Uncommon Diseases

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191501)。

摘　　要：目的探讨针对慢阻肺并伴呼吸衰竭的患者,应用无创正压机械通气的方法对于动脉血气指标影响。方法纳入的96例满足标准病例对象,通过随机分组的原则,分成了观察组、对照组的两组,都是每组的患者48例。针对各组的患者应用不同治疗干预方式,对照组患者进行常规的方法干预,而观察组则常规护理并同时配合无创正压机械通气的方法进行干预。结果对于患者在临床疗效、动脉血气指标前后改变的情况记录,同时进行肺功能的指标以及炎症指标的检测以及对比,统计并发症发生以及组间的差异。结果疗效表现为观察组要比对照组患者更高治疗有效率,组间的指标结果差异明显(P<0.05);两组患者治疗7d后的PaCO_(2)、CRP、IL-6、TNF-α水平均较治疗前有所降低,但观察组指标水平明显更低于对照组(P<0.05);治疗期间在动脉血PH值、PaO_(2)、FEV1、FVC、FEV1/FVC指标水平均较治疗前提高,但观察组指标水平高于对照组(P<0.05);并发症的数据结果对比,组间无差异性(P>0.05)。结论慢阻肺伴呼吸衰竭的患者,常规的干预基础上,进行无创正压机械通气的方法,能够很好地改善患者动脉血气指标,降低炎症并且可以明显地提高肺功能,此外也不会增加治疗的过程并发症发生,具有很好应用效果及推广价值。Objective To investigate the impact of noninvasive positive pressure ventilation on arterial blood gas parameters in patients with chronic obstructive pulmonary disease(COPD)and respiratory failure.Methods A total of 96 eligible patients were randomly assigned to either the observation group or the control group,with 48 patients in each group.The control group received routine treatment,while the observation group received routine care in addition to noninvasive positive pressure ventilation.The clinical efficacy,changes in arterial blood gas parameters,pulmonary function indices,and inflammatory markers were recorded and compared between the two groups.Complications and differences between the groups were also assessed.Results The observation group showed a significantly higher treatment effectiveness compared to the control group,with significant differences in the measured parameters(P<0.05).After 7 days of treatment,the levels of PaCO_(2),CRP,IL-6,and TNF-αdecreased in both groups,but the observation group had significantly lower levels compared to the control group(P<0.05).The arterial blood pH,PaO_(2),FEV1,FVC,and FEV1/FVC levels improved in both groups during treatment,but the observation group had significantly higher levels compared to the control group(P<0.05).There was no significant difference in complications between the groups(P>0.05).Conclusion In patients with COPD and respiratory failure,noninvasive positive pressure ventilation in addition to routine interventions can effectively improve arterial blood gas parameters,reduce inflammation,and significantly enhance pulmonary function.Furthermore,it does not increase the occurrence of complications during treatment,indicating its potential value and applicability.

关 键 词：慢阻肺 呼吸衰竭 无创正压机械通气 动脉血气分析 肺功能 炎症因子 

分 类 号：R563.8[医药卫生—呼吸系统]