摘要
目的:探讨无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床疗效。方法:选取江苏大学附属澳洋医院2019年1月-2021年8月收治的COPD合并呼吸衰竭患者70例,按照随机数字表法分为观察组和对照组,各35例。对照组采用吸氧、抗炎、祛痰、平喘、纠正水电解质紊乱等常规治疗,并给予纳洛酮2 mg加入60 mL生理盐水,微量泵静脉泵入,2次/d,24 h持续泵入,连续治疗3 d。观察组在对照组治疗基础上采用无创呼吸机,参数设置S/T模式,初始吸气正压6~8 cmH_(2)O,呼气正压2~3 cmH_(2)O,氧流量3~8 L/min,4~6 h/次,2~3次/d,连续治疗3 d。观察两组患者治疗72 h的血氧饱和度(SaO_(2)),血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH],生命体征(心率、呼吸)变化情况,并评估生活质量。结果:两组患者入院时SaO_(2)、血气指标和生命体征比较差异无统计学意义(P>0.05);与入院时比较,两组治疗72 h后的pH、PaO_(2)、SaO_(2)指标明显升高,PaCO_(2)、心率、呼吸指标明显降低,差异有统计学意义(P<0.05)。观察组治疗72 h后心率、呼吸与对照组比较,差异无统计学意义(P>0.05);pH、PaO_(2)、PaCO_(2)、SaO_(2)与对照组比较,差异有统计学意义(P<0.05)。观察组治疗72 h后生活质量评分均优于对照组,差异有统计学意义(P<0.05)。结论:无创呼吸机治疗COPD合并呼吸衰竭患者疗效显著,值得推广。
Objective:To explore the clinical efficacy of non-invasive ventilator in the treatment of chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:A total of 70 COPD patients with respiratory failure treated in Aoyang Hospital Affiliated to Jiangsu University from January 2019 to August 2021 were collected and divided into observation group and control group according to random number table,with 35 cases in each group.The control group received conventional treatment,including oxygen inhalation,anti-inflammatory,expectorant,antiasthmatic,correction of water and electrolyte balance,and was given naloxone 2 mg in 60 mL normal saline,which was pumped intravenously using micropump,twice a day,and pumped continuously for 24 hours.The treatment lasted for 3 days.The observation group was treated with non-invasive ventilator on the basis of the control group.The parameters were set as follows:S/T mode,initial positive inspiratory pressure 6-8 cmH_(2)O,positive expiratory pressure 2-3 cmH_(2)O,oxygen flow 3-8 L/min,4-6 h/time,2-3 times/day.The treatment also lasted for 3 days.The changes in blood oxygen saturation(SaO_(2)),blood gas indicators[partial pressure of arterial oxygen(PaO_(2)),partial pressure of arterial carbon dioxide(PaCO_(2)),pH],vital signs(heart rate,respiration)of the two groups were observed after 72 hours of treatment,and quality of life was assessed.Results:There were no significant differences in SaO_(2),blood gas indexes and vital signs between the two groups at admission(P>0.05).Compared with the indexes at admission,the pH,PaO_(2) and SaO_(2) indexes of the two groups increased significantly after 72 hours of treatment,and the PaCO_(2),heart rate and respiratory indexes decreased significantly,with statistically significant differences(P<0.05).There was no significant difference in heart rate and respiration between the observation group and the control group after 72 hours of treatment(P>0.05),and the difference in pH,PaO_(2),PaCO_(2) and SaO_(2) between the observation group and the control group was statistically significant(P<0.05).The quality of life scores of the observation group after 72 hours of treatment were all better than those of the control group,with a statistically significant difference(P<0.05).Conclusion:Non-invasive ventilator is significantly effective in treating COPD complicated with respiratory failure.It deserves the promotion.
作者
潘建新
靳凤娟
Pan Jian-xin;Jin Feng-juan(Aoyang Hospital Affiliated to Jiangsu University,Zhangjiagang 215600,Jiangsu Province,China)
出处
《中国社区医师》
2022年第29期40-42,共3页
Chinese Community Doctors
关键词
无创呼吸机
慢性阻塞性肺疾病
呼吸衰竭
血氧饱和度
Non-invasive ventilator
Chronic obstructive pulmonary disease
Respiratory failure
Blood oxygen saturation
