摘要
目的 探讨早期应用无创通气治疗慢性阻塞性肺疾病(COPD)急性呼吸衰竭的价值。方法 56例COPD急性加重合并Ⅱ型呼吸衰竭患者随机分为对照组和实验组,每组28例。对照组用常规药物治疗,实验组用常规药物治疗加无创正压通气。结果 两组患者治疗前的基础情况和血气指标差异元显著性(P>0.05)。治疗后呼吸频率(RR)、心率(HR)、动脉血pH、氧分压(PaO_2)、二氧化碳分压(PaCO_2)均明显改善(P<0.01)。总有效率实验组和对照组分别为89.3％和82.1％,差异无统计学意义(P>0.05),但实验组与对照组比较,治疗后PaO_2上升更明显(P<0.01),PaCO_2下降更明显(P<0.01)。实验组和对照组平均住院日分别为(13±5)d和(17±6)d(P<0.01);治疗4h后实验组和对照组呼吸困难明显缓解的人数分别为19例和9例(P<0.01),48h后分别为24例和16例(P<0.05)。需气管插管有创通气者分别为3例(10.7％)和5例(17.9％)(P>0.05)。结论 早期应用无创通气治疗COPD急性呼吸衰竭较仅用常规药物治疗能更快地缓解临床症状,提高PaO_2和降低PaCO_2。
Objective To evaluate the clinical value of early use of noninvasive ventilation in COPD patients with exacerbated respiratory failure.Methods 56 Patients were randomizedly received conventional medical therapy (control group)or conventional medical therapy plus noninvasive ventilation (trial group) .Results Two groups had similar clinical characteristics and gas exchange profile before treatment. After treatment the respiratory rate, heart rate, pH.PaO2, and PaCO2 improved significantly compared with baseline in two groups( P < 0.01) ; the total efficacy rate of trial group vs control group was 89.3% vs 82.1%(P>0.05) .respectively.But improvements in PaO2,PaCO2 and dyspnea in trial group were much better than those in control group(P<0.01); the average duration of hospitalization was shorter in trial group(13±5)days than that in control group (17±6)days(P<0.01) .There were 3 patients in trial group who needed endotracheal intubation and invasive ventilation while 5 patienes in control group(P>0.05) .Conclusion The early use of noninvasive ventilation in COPD patients with exacerbated respiratory failure can rapidly improve clinical symptoms and arterial blood gases.
出处
《中国呼吸与危重监护杂志》
CAS
2002年第4期233-235,共3页
Chinese Journal of Respiratory and Critical Care Medicine
