无创呼吸机治疗COPD急性加重合并Ⅱ型呼吸衰竭临床分析(1)
【摘要】 目的：探讨分析慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭患者采用无创呼吸机治疗的临床疗效。方法：将笔者所在医院收治的64例AECOPD合并Ⅱ型呼吸衰竭患者按照随机数字表法分为观察组(在常规治疗基础上采用无创呼吸机治疗)和对照组(单独采用常规方法治疗)，对比观察两组患者治疗前后呼吸频率、心率、各项血气分析指标变化情况及两组患者住院时间、死亡率。结果：两组患者经治疗后，RR、HR等指标较治疗前均有所下降(P<0.05)，两组患者PaO2、SaO2指标水平均有所升高，而PaCO2水平较治疗前有所下降(P<0.05)，但是观察组治疗后HR、RR、SaO2、PaO2、PaCO2等各项指标均优于对照组(P<0.05)。观察组患者住院时间(13.9±2.3)d明显短于对照组(21.9±4.9)d，且观察组患者死亡率(3.1%)明显低于对照组(9.4%)，差异均有统计学意义(P<0.05)。结论：AECOPD合并Ⅱ型呼吸衰竭患者采用无创呼吸机治疗的临床疗效显著，可有效改善患者的临床症状，降低死亡率，缩短住院时间，促进患者尽早康复，值得在临床上进一步推广、应用。
【关键词】 COPD急性加重； Ⅱ型呼吸衰竭； 无创呼吸机
中图分类号 R563.8 文献标识码 A 文章编号 1674-6805(2015)10-0006-03
【Abstract】 Objective：To study the clinical curative effect of noninvasive ventilator in the treatment of chronic obstructive pulmonary diseases acute exacerbation(AECOPD) with type Ⅱ respiratory failure.Method：64 cases of AECOPD with type Ⅱ respiratory failure in our hospital according to random number table method were divided into the observation group(on the basis of conventional treatment using noninvasive ventilator therapy) and the control group(with conventional treatment alone)，before and after treatment breathing rate，heart rate，blood gas analysis index changes，length of hospital stay，mortality of two groups were compared.Result：Two groups of patients after treatment，RR，HR and other indicators before treatment were decreased(P<0.05)，PaO2，SaO2 index level of two groups were increased，PaCO2 level fell compared with before treatment(P<0.05)，but HR，RR，SaO2，PaO2 and PaCO2 of the observation group after treatment，the indicators were better than those of the control group(P<0.05).The hospital time of the observation group(13.9±2.3)d were significantly shorter than that of the control group(21.9±4.9)d，and mortality rate of the observation group(3.1%) was obviously lower than that of the control group(9.4%)，there was statistically significant difference(P<0.05).Conclusion：AECOPD with type Ⅱ respiratory failure patients using noninvasive ventilator therapy clinical curative effect is distinct，can effectively improve the patient’s clinical symptoms，lower mortality rate，shorten hospitalization time，promote the patient recover as soon as possible，is worth of further promotion and application in clinic.
【Key words】 COPD exacerbation； Type Ⅱ respiratory failure； Noninvasive ventilator
First-author’s address：Taixing Chinese Medicine Hospital，Taixing 225400，China
doi：10.14033/j.cnki.cfmr.2015.10.003
慢性阻塞肺疾病(COPD)是临床常见的多发疾病，在患者急性加重期很容易并发Ⅱ型呼吸衰竭，病情非常危重[1-2]。临床上常采用祛痰、吸氧、抗感染、平喘等常规手段治疗，但临床疗效难以令人满意。机械通气治疗是临床纠正患者缺氧症状的重要手段，但是一般都是采用气管切开、气管插管等有创操作，长时间通气患者的耐受性较差，也容易并发各种并发症[3-4]。近年来，随着无创呼吸机通气的广泛普及应用，其临床疗效也得到了广大学者的认可，目前已成为临床治疗AECOPD合并Ⅱ型呼吸衰竭的主要手段[5-6]。为进一步分析AECOPD合并Ⅱ型呼吸衰竭患者采用无创呼吸机治疗的临床疗效，本文对笔者所在医院收治的64例患者临床治疗情况进行回顾性分析，现报道如下。, 百拇医药(高卫星)
【关键词】 COPD急性加重； Ⅱ型呼吸衰竭； 无创呼吸机
中图分类号 R563.8 文献标识码 A 文章编号 1674-6805(2015)10-0006-03
【Abstract】 Objective：To study the clinical curative effect of noninvasive ventilator in the treatment of chronic obstructive pulmonary diseases acute exacerbation(AECOPD) with type Ⅱ respiratory failure.Method：64 cases of AECOPD with type Ⅱ respiratory failure in our hospital according to random number table method were divided into the observation group(on the basis of conventional treatment using noninvasive ventilator therapy) and the control group(with conventional treatment alone)，before and after treatment breathing rate，heart rate，blood gas analysis index changes，length of hospital stay，mortality of two groups were compared.Result：Two groups of patients after treatment，RR，HR and other indicators before treatment were decreased(P<0.05)，PaO2，SaO2 index level of two groups were increased，PaCO2 level fell compared with before treatment(P<0.05)，but HR，RR，SaO2，PaO2 and PaCO2 of the observation group after treatment，the indicators were better than those of the control group(P<0.05).The hospital time of the observation group(13.9±2.3)d were significantly shorter than that of the control group(21.9±4.9)d，and mortality rate of the observation group(3.1%) was obviously lower than that of the control group(9.4%)，there was statistically significant difference(P<0.05).Conclusion：AECOPD with type Ⅱ respiratory failure patients using noninvasive ventilator therapy clinical curative effect is distinct，can effectively improve the patient’s clinical symptoms，lower mortality rate，shorten hospitalization time，promote the patient recover as soon as possible，is worth of further promotion and application in clinic.
【Key words】 COPD exacerbation； Type Ⅱ respiratory failure； Noninvasive ventilator
First-author’s address：Taixing Chinese Medicine Hospital，Taixing 225400，China
doi：10.14033/j.cnki.cfmr.2015.10.003
慢性阻塞肺疾病(COPD)是临床常见的多发疾病，在患者急性加重期很容易并发Ⅱ型呼吸衰竭，病情非常危重[1-2]。临床上常采用祛痰、吸氧、抗感染、平喘等常规手段治疗，但临床疗效难以令人满意。机械通气治疗是临床纠正患者缺氧症状的重要手段，但是一般都是采用气管切开、气管插管等有创操作，长时间通气患者的耐受性较差，也容易并发各种并发症[3-4]。近年来，随着无创呼吸机通气的广泛普及应用，其临床疗效也得到了广大学者的认可，目前已成为临床治疗AECOPD合并Ⅱ型呼吸衰竭的主要手段[5-6]。为进一步分析AECOPD合并Ⅱ型呼吸衰竭患者采用无创呼吸机治疗的临床疗效，本文对笔者所在医院收治的64例患者临床治疗情况进行回顾性分析，现报道如下。, 百拇医药(高卫星)