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目的探讨慢性阻塞性肺疾病合并呼吸衰竭采用无创正压通气(NIPPV)治疗临床效果。方法本次选择的100例慢性阻塞性肺疾病合并呼吸衰竭患者,均为郑州大学第一附属医院2012年9月至2013年9月收治,采用数字表抽取法随机分组,对常规方案治疗(对照组,n=50)与采用无创正压通气治疗(观察组,n=50)临床效果进行比较。结果观察2组治疗3h后情况,与治疗前比较,观察组PaO2和pH值明显提高,呼吸频率和心率减慢,PaCO2明显下降,均有统计学差异(P<0.05)。对照组与治疗前比较,PaCO2下降显著(P<0.05),其它虽有程度不等改善,但不具统计学差异(P>0.05)。观察组选取病例基本痊愈率为96%,气管插管率为10%,死亡率为4%;对照组分别为64%,30%,10%,差异均有统计学意义(P<0.05)。观察组抗生素平均应用时间及住院天数少于对照组,有统计学差异(P<0.05)。结论慢性阻塞性肺疾病合并呼吸衰竭的患者采用无创正压通气方案治疗,为呼吸衰竭的纠正提供了有力保障,效果确切,对加快病情康复,提高患者生存质量有非常重要的意义。
Objective To investigate the clinical effect of noninvasive positive pressure ventilation (NIPPV) in patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods The 100 patients with chronic obstructive pulmonary disease and respiratory failure were selected and admitted to the First Affiliated Hospital of Zhengzhou University from September 2012 to September 2013. The patients were randomly divided into three groups according to the routine regimen (control Group, n = 50) compared with the non-invasive positive pressure ventilation treatment (observation group, n = 50). Results After 3 hours of treatment, the PaO2 and pH values of the observation group were significantly increased, the respiratory rate and heart rate were slowed down, and the PaCO2 was significantly decreased (all P <0.05). PaCO2 decreased significantly in the control group compared with before treatment (P <0.05), while the others did not show any significant improvement (P> 0.05). In the observation group, the basic recovery rate was 96%, the endotracheal intubation rate was 10%, and the mortality rate was 4%. The control group was 64%, 30% and 10% respectively. The difference was statistically significant (P <0.05). The average antibiotic application time and hospitalization days in the observation group were less than those in the control group, with statistical significance (P <0.05). Conclusion The patients with chronic obstructive pulmonary disease and respiratory failure are treated with noninvasive positive pressure ventilation, which provides a powerful guarantee for the correction of respiratory failure. The exact effect is very important to speed up the recovery and improve the quality of life of patients.