摘要
目的观察时间控制通气(ST)模式对慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者血气分析和呼吸力学指标的影响。方法前瞻性分析2016年1月至2019年12月首都医科大学大兴教学医院收治的180例COPD合并Ⅱ型呼吸衰竭患者的病例资料,随机数字表法分为观察组和对照组,每组各90例。观察组给予双水平ST模式无创呼吸机治疗,对照组给予持续气道正压通气(CPAP)治疗。比较两组患者治疗前后血气分析和呼吸力学指标、症状消失时间及不良反应发生情况。结果治疗前,两组患者的血气指标及呼吸力学指标比较,差异无统计学意义(P> 0.05);治疗后观察组患者pH、动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、动脉血二氧化碳分压(PaCO2)分别为7.45±0.31、(82.36±5.19) mmHg、(91.59±5.14)%、(55.78±4.13) mmHg,与对照组的7.34±0.52、(73.26±4.36) m Hg、(84.94±5.22)%、(63.40±5.42) mmHg比较,差异均有统计学意义(P <0.05);观察组患者治疗后呼吸频率(f)、潮气量(VT)、吸气时间分数(Ti/T)分别为(16.38±1.34)次/min、(425.24±52.42) ml、(36.59±1.26)%,与对照组治疗后的(18.34±1.32)次/min、(392.42±40.24) ml、(33.48±1.16)%比较,差异均有统计学意义(P <0.05)。观察组患者的哮鸣音、喘息、气促等症状消失时间分别为(2.83±0.36) d、(2.03±0.14) d、(2.13±0.14) d、(5.13±1.36) d,明显低于对照组的(5.29±1.27) d、(3.49±0.25) d、(3.89±0.28) d、(7.29±1.27) d,差异均有统计学意义(P <0.05)。观察组患者的不良反应发生率(10.0%)与对照组(13.3%)比较,差异无统计学意义(P> 0.05)。结论 ST模式无创通气治疗COPD合并Ⅱ型呼吸衰竭,对患者血气指标、呼吸指标改善作用显著,有利于症状缓解,安全性高,值得临床推广。
Objective To observe the effect of time-controlled ventilation(ST)mode on blood gas analysis and respiratory mechanics indexes of patients with chronic obstructive pulmonary disease(COPD)combined with type Ⅱ respiratory failure.Methods The clinical data of 180 COPD patients with type Ⅱ respiratory failure admitted to Daxing Teaching Hospital of Capital Medical University from January 2016 to December 2019 were prospectively analyzed.Random number table method was used to divide the patients into observation group and control group,with 90 cases in each group.The observation group was treated with a bilevel ST mode non-invasive ventilator,and the control group was treated with continuous positive airway pressure(CPAP).The blood gas analysis,respiratory mechanics indexes,time of symptom disappearance and adverse reactions were compared between the two groups of patients before and after treatment.Results Before treatment,there was no significant difference in blood gas indexes and respiratory mechanics indexes between the two groups of patients(P>0.05);after treatment,the pH,PaO2,SaO2,and PaCO2 of the observation group were(7.45±0.31)and(82.36±5.19)mmHg,(91.59±5.14)%,(55.78±4.13)mmHg,compared with the control group,the difference was statistically significant(P<0.05).f,VT and Ti/T after treatment in the observation group were(16.38±1.34)times/min,(425.24±52.42)ml,(36.59±1.26)%,and the differences were statistically significant compared with before treatment(P<0.05),compared with(18.34±1.32)times/min,(392.42±40.24)ml,(33.48±1.16)%after treatment in the control group,the difference was statistically significant(t=4.206,6.826,5.310,P<0.05).Comparison of the disappearance of wheezing,wheezing,shortness of breath and other symptoms in the observation group and the control group were(2.83±0.36)d vs.(5.29±1.27)d,(2.03±0.14)d vs.(3.49±0.25)d,(2.13±0.14)d vs.(3.89±0.28)d,(5.13±1.36)d vs.(7.29±1.27)d,the difference was statistically significant(P<0.05).The difference was statistically significant(P<0.05).Compared with the control group(13.3%),the incidence of adverse reactions in the observation group(10.0%)was not statistically significant(P>0.05).Conclusion ST-mode non-invasive ventilation in the treatment of COPD combined with type Ⅱ respiratory failure has a significant effect on improving the blood gas and respiratory indicators of patients,is conducive to symptom relief,has high safety,and is worthy of clinical promotion.
作者
杨慧亮
李颖
巴晓彤
YANG Hui-liang;LI Ying;BA Xiao-tong(Department of Emergency Medicine,Capital Medical University Daxing Teaching Hospital,Beijing 102600,China)
出处
《临床和实验医学杂志》
2020年第18期1937-1940,共4页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金青年项目(编号:81700007)。
关键词
COPD
Ⅱ型呼吸衰竭
时间控制通气
血气分析
呼吸力学
不良反应
COPD
TypeⅡrespiratory failure
Time control ventilation
Blood gas analysis
Respiratory mechanics
Adverse reactions
