无创正压机械通气治疗AECOPD合并呼吸衰竭的效果  

Effect of Non-Invasive Positive Pressure Mechanical Ventilation for AECOPD Combined With Respiratory Failure

作　　者：刘成林[1] 刘海洋 LIU Chenglin;LIU Haiyang(Department of Respiratory and Critical Care Medicine,Dongtai People's Hospital,Dongtai Jiangsu 224200,China)

机构地区：[1]东台市人民医院呼吸与危重症医学科,江苏东台224200

出　　处：《中国卫生标准管理》2024年第14期92-95,共4页China Health Standard Management

摘　　要：目的对比慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并呼吸衰竭(respiratory failure,RF)患者应用无创正压机械通气(noninvasive positive pressure ventilation,NPPV)与常规对症治疗在治疗效果之间的差异及2种治疗方式对血气指标、肺相关功能的影响。方法回顾性分析东台市人民医院2021年1月—2023年6月收治的82例AECOPD合并RF患者。按照治疗方法的差异分为常规组、NPPV组,各41例。对比2组患者肺功能情况、血气指标、生命体征指标、临床疗效和不良反应发生情况。结果NPPV组治疗后用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in the first second,FEV_(1))、第1秒用力呼气容积占用力肺活量的比例(forced expiratory volume in the first second/forced vital capacity,FEV_(1)/FVC)、动脉血氧分压(partial pressure of oxygen in arterial blood,PaO_(2))高于常规组,而动脉血二氧化碳分压(partial pressure of carbon dioxide in arterial blood,PaCO_(2))低于常规组(P<0.05);NPPV组治疗后的呼吸频率、心率、平均动脉压均低于常规组(P<0.05);NPPV组总有效率为95.12%,高于常规组的73.17%(P<0.05);NPPV组不良反应总发生率为7.32%,低于常规组的26.83%(P<0.05)。结论NPPV治疗能够让AECOPD合并RF患者的肺功能得以提高,临床治疗效果较好,改善其血氧方面的指标及预后。Objective To compare the therapeutic effect difference between noninvasive positive pressure ventilation(NPPV)and conventional symptomatic treatment in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with respiratory failure(RF),and the effects of the two treatments on blood gas indexes and lung function.Methods A total of 82 patients with AECOPD combined with RF admitted to Dongtai People's Hospital from January 2021 to June 2023 were retrospectively analyzed.According to the difference of treatment methods,they were divided into routine group and NPPV group,41 cases each.Lung function,blood gas index,vital signs index,clinical efficacy and adverse reactions were compared between the two groups.Results After treatment,forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1)),forced expiratory volume in the first second/forced vital capacity(FEV_(1)/FVC)and partial pressure of oxygen in arterial blood(PaO_(2))in NPPV group were higher than those in routine group,while the partial pressure of carbon dioxide in arterial blood(PaCO_(2))was lower than that in routine group(P<0.05).After treatment,the respiratory rate,heart rate,and mean arterial pressure of NPPV group were lower than those of routine group(P<0.05).The total effective rate of NPPV group was 95.12%,which was higher than 73.17%of conventional group(P<0.05).The total incidence of adverse reactions in NPPV group was 7.32%,which was lower than 26.83%in conventional group(P<0.05).Conclusion NPPV treatment can improve the lung function of AECOPD patients with RF,and the clinical treatment effect is good,improving the blood oxygen index and prognosis.

关 键 词：无创正压机械通气 呼吸衰竭 肺功能 血气指标 慢性阻塞性肺疾病急性加重期 疗效 

分 类 号：R563[医药卫生—呼吸系统]