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目的:观察大承气汤灌肠辅助有创机械通气治疗慢性阻塞性肺疾病(COPD)呼吸衰竭的疗效。方法:将76例COPD呼吸衰竭患者随机均分2组,对照组给予有创机械通气及常规西医治疗方法,治疗组在对照组治疗的基础上给予大承气汤灌肠辅助治疗。观察2组治疗2~3天后的肺动态顺应性(Cdyn)、氧合指数(OI),治疗1疗程后观察比较患者的机械通气及住院时间、血气指标[动脉血氧分压(Pa O2)、二氧化碳分压(Pa CO2)]、并发症[气道黏膜损伤、腹胀、呕吐、呼吸机相关性肺炎(VAP)]发生状况、死亡率。结果:治疗后,2组Pa O2及Pa CO2均较治疗前好转(P<0.05),但2组间比较,差异均无统计学意义(P>0.05)。2组Cdyn、OI均较治疗前改善,且治疗组改善效果优于对照组(P<0.05);治疗组机械通气及住院时间均短于对照组(P<0.05)。治疗组腹胀、VAP发生率和死亡率均低于对照组(P<0.05)。结论:大承气汤灌肠辅助治疗COPD呼吸衰竭可提高疗效,减少并发症和死亡情况的发生。
Objective: To observe the effect of Dachengqi Decoction assisted invasive mechanical ventilation on chronic obstructive pulmonary disease (COPD) respiratory failure. Methods: A total of 76 COPD patients with respiratory failure were randomly divided into two groups. The control group was given invasive mechanical ventilation and conventional western medicine. The treatment group was given Dachengqi Decoction adjuvant therapy on the basis of the control group. The dynamic compliance (Cdyn) and oxygenation index (OI) of 2 groups after 2 to 3 days of treatment were observed. After 1 course of treatment, the mechanical ventilation and hospital stay were observed and compared. Blood gas index (Pa O2) , PaCO 2], complications [airway mucosal injury, bloating, vomiting, ventilator-associated pneumonia (VAP)] and mortality. Results: After treatment, the PaO 2 and PaCO 2 in both groups improved compared with those before treatment (P <0.05), but there was no significant difference between the two groups (P> 0.05). The Cdyn and OI in both groups were better than those before treatment, and the improvement in the treatment group was better than that in the control group (P <0.05). The mechanical ventilation and hospital stay in the two groups were shorter than those in the control group (P <0.05). Abdominal distension, VAP incidence and mortality in treatment group were lower than those in control group (P <0.05). Conclusion: Dachengqi Decoction adjuvant treatment of COPD respiratory failure can improve the curative effect and reduce the incidence of complications and death.