无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的临床效果

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目的:探讨无创正压通气(Non-vasive Pressure Present Ventilation,NIPPV)对慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Diseases,COPD)合并Ⅱ型呼吸衰竭(TypeⅡrespiratory failure)患者肺功能及动脉血气分析的影响。方法:选择2013年8月-2015年8月在我院接受治疗的慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者100例,根据治疗方法不同,将所选研究对象分为研究组及对照组,每组50例。对照组患者实施鼻导管吸氧,研究组患者采用无创正压通气治疗。观察并比较两组患者治疗前后的动脉血气分析结果、肺功能指标的变化情况以及临床疗效。结果:与治疗前比较,两组患者治疗后FEV1/FVC,FEV1及MVV均升高,且研究组高于对照组,差异均具有统计学意义(P<0.05)。治疗后,两组患者p H及PaO_2均较治疗前明显上升,PaCO_2则明显下降,差异具有统计学意义(P<0.05);治疗后,研究组pH及PaO_2高于对照组,而PaCO_2低于对照组,差异具有统计学意义(P<0.05)。研究组总有效率(92.5%)显著高于对照组(75.6%),差异具有统计学意义(P<0.05)。结论:无创正压通气能够改善慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的肺功能及动脉血气分析结果,具有显著的临床疗效,值得进一步推广应用。 Objective: To investigate the effect of Non-vasive Pressure Present Ventilation (NIPPV) on pulmonary function and arterial blood gas analysis in patients with chronic obstructive pulmonary disease (COPD) and type Ⅱ respiratory failure. Methods: One hundred patients with chronic obstructive pulmonary disease and type Ⅱ respiratory failure who were treated in our hospital from August 2013 to August 2015 were selected. According to the different treatment methods, the selected subjects were divided into study group and control group, 50 cases in each group. Patients in the control group received nasal catheter oxygen inhalation, and patients in the study group received noninvasive positive pressure ventilation. The results of arterial blood gas analysis before and after treatment, changes in lung function indexes and clinical efficacy were observed and compared between the two groups. Results: Compared with those before treatment, the FEV1 / FVC, FEV1 and MVV in both groups increased after treatment, and the difference between the two groups was statistically significant (P <0.05). After treatment, p H and PaO 2 in both groups increased significantly compared with those before treatment and PaCO 2 decreased significantly (P 0. 05). After treatment, the pH and PaO 2 in the study group were higher than those in the control group, while PaCO 2 was lower than Control group, the difference was statistically significant (P <0.05). The total effective rate (92.5%) in the study group was significantly higher than that in the control group (75.6%), the difference was statistically significant (P <0.05). Conclusion: Noninvasive positive pressure ventilation can improve lung function and arterial blood gas analysis in patients with chronic obstructive pulmonary disease and respiratory failure type Ⅱ. It has significant clinical curative effect and is worthy of further popularization and application.
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