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目的探讨家庭无创通气对慢性阻塞性肺疾病(COPD)并呼吸衰竭患者营养状况及免疫功能的影响。方法选择2008年1月至2013年1月接受无创通气并携带家庭型BiPAP呼吸机返家继续无创通气及吸氧的COPD并呼吸衰竭患者25例(实验组),以同期同病情住院期间接受无创通气,出院后停用无创通气而改用吸氧治疗的COPD并呼吸衰竭患者27例(对照组)。两组均每天治疗15 h,观察时间为6个月,且两组的支气管舒张及化痰等治疗相同,两组患者按需个体化提供膳食。观察两组患者血气分析指标、体质指数(BMI)、血清总蛋白(STP)、白蛋白(ALB)、球蛋白(GLB)、IgG、IgM、IgA浓度及外周血总淋巴细胞计数(TLC),比较各组治疗前后两组间各项观察指标的变化。结果实验组治疗前后动脉血气指标PO2、PCO2比较差异无统计学意义(P>0.05),患者的低氧血症及高碳酸血症基本纠正,而对照组治疗前后动脉血气指标PO2、PCO2比较差异有统计学意义(P<0.05)。实验组BMI、STP、ALB、GLB、IgG、IgA、TLC显著高于治疗前及对照组(P<0.05);对照组营养指标及免疫指标各项参数均无显著变化(P>0.05)。结论家庭无创通气可以改善COPD并呼吸衰竭患者的营养状况及免疫功能。
Objective To investigate the effects of home-based noninvasive ventilation on nutritional status and immune function in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. METHODS: From January 2008 to January 2013, 25 patients (experimental group) with noninvasive ventilation and home-based BiPAP ventilator to continue non-invasive ventilation and oxygen inhalation to continue COPD and respiratory failure were enrolled in this study. Non-invasive Ventilation, discharged after discharge of non-invasive ventilation and switch to oxygen therapy in COPD and respiratory failure in 27 patients (control group). Both groups were treated 15 h daily for 6 months, and the two groups had the same treatment of bronchial diastole and phlegm, and the two groups were provided on-demand individualized diet. Blood gas analysis index, body mass index (BMI), serum total protein (STP), albumin (ALB), globulin (GLB), IgG, IgM and IgA concentrations and total peripheral blood lymphocyte count (TLC) The changes of each observation index between the two groups before and after treatment were compared. Results Before and after treatment, arterial blood gas index PO2 and PCO2 in experimental group had no significant difference (P> 0.05), hypoxemia and hypercapnia in the experimental group were basically corrected, while arterial blood gas index PO2 and PCO2 in the control group before and after treatment were significantly different There was statistical significance (P <0.05). The levels of BMI, STP, ALB, GLB, IgG, IgA and TLC in the experimental group were significantly higher than those before treatment and in the control group (P <0.05). No significant changes were found in the indexes of the nutritional and immune parameters in the control group (P> 0.05). Conclusion Non-invasive ventilation can improve the nutritional status and immune function of patients with COPD and respiratory failure.