无创正压通气联合呼吸兴奋剂治疗慢性阻塞性肺疾病急性呼吸衰竭的效果分析  

Effect of noninvasive positive pressure ventilation combined with respiratory stimulants on acute respiratory failure in patients with chronic obstructive pulmonary disease

作　　者：梁润泽 韦晓婷 LIANG Run-ze;WEI Xiao-ting(Department of Respiratory and Critical Care Medicine,Yangjiang People's Hospital,Yangjiang 529500,China)

机构地区：[1]阳江市人民医院呼吸与危重症医学科,广东阳江529500

出　　处：《中国处方药》2024年第3期193-196,共4页Journal of China Prescription Drug

基　　金：2021年阳江市卫生健康局科技计划项目(阳卫健2021025)

摘　　要：目的探讨无创正压通气联合呼吸兴奋剂在慢性阻塞性肺疾病急性呼吸衰竭患者中的效果。方法选择2021年3月~2023年6月慢性阻塞性肺疾病急性呼吸衰竭患者94例为对象,随机数字表法分为两组各47例。对照组采用药物(呼吸兴奋剂)+氧疗,治疗组在对照组基础上联合无创呼吸机治疗,两组治疗3 d及7 d评估患者效果,比较两组呼吸、神志、心率、血气、C反应蛋白(CRP)变化、病死率及安全性。结果两组治疗7 d后患者呼吸、神志、心率及CRP水平得到改善;观察组呼吸、心率及CRP水平低于对照组(P<0.05);神志评分高于对照组(P<0.05);两组治疗7 d后pH水平差异无统计学意义(P>0.05);观察组PaO_(2)水平高于对照组(P<0.05);PaCO_(2)水平低于对照组(P<0.05);观察组治疗7 d后病死率低于对照组(P<0.05);两组再次插管、误吸、谵妄、恶心呕吐发生率差异无统计学意义(P>0.05)。结论无创正压通气联合呼吸兴奋剂用于慢性阻塞性肺疾病急性呼吸衰竭患者中,能改善患者呼吸、神志、心率及血气水平,可降低CRP水平,获得良好的预后,不增加不良反应发生率。Objective To investigate the effect of noninvasive positive pressure ventilation combined with respiratory stimulants in patients with acute respiratory failure caused by chronic obstructive pulmonary disease.Methods From March 2021 to June 2023,94 patients with acute respiratory failure caused by chronic obstructive pulmonary disease were selected as subjects.They were randomly divided into two groups with 47 cases in each group.The control group was treated with drugs(respiratory stimulants)and oxygen therapy,while the treatment group was treated with non-invasive ventilation on the basis of the control group.The efficacy of the two groups was evaluated for 3 and 7 days of treatment,and changes in breathing,consciousness,heart rate,blood gas,C-reactive protein(CRP),mortality rate,and safety were compared between the two groups.Results After 7 days of treatment,the respiratory,mental,heart rate,and CRP levels of patients in both groups improved;The respiratory,heart rate,and CRP levels in the observation group were lower than those in the control group(P<0.05);The mental state score was higher than that of the control group(P<0.05);There was no statistically significant difference in pH levels between the two groups after 7 days of treatment(P>0.05);The PaO_(2) level in the observation group was higher than that in the control group(P<0.05);The level of PaCO_(2) was lower than that of the control group(P<0.05);The mortality rate of the observation group after 7 days of treatment was lower than that of the control group(P<0.05);There was no statistical difference in the incidence of reintubation,aspiration,delirium,and nausea and vomiting between the two groups(P>0.05).Conclusion Non invasive positive pressure ventilation combined with respiratory stimulants in patients with acute respiratory failure caused by chronic obstructive pulmonary disease can improve the level of respiration,consciousness,heart rate and blood gas,reduce the level of CRP,obtain good prognosis,and do not increase the incidence of adverse r

关 键 词：无创正压通气 呼吸兴奋剂 慢性阻塞性肺疾病 急性呼吸衰竭 C反应蛋白 

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