无创性通气治疗慢性阻塞性肺疾病呼吸衰竭并发上消化道出血的因素探讨

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英文篇名：Factors of Noninvasive Ventilation in the Treatment of Chronic Obstructive Pulmonary Disease Respiratory Failure Complicated with Upper Gastrointestinal Hemorrhage 作者：伏鑫 ; 赵继学 英文作者：FU Xin;ZHAO Jixue;China-Japan Union Hospital of Jilin University;The First Hospital of Jilin University; 关键词：无创性通气 ; 慢性阻塞性肺疾病呼吸衰竭 ; 上消化道出血 英文关键词：noninvasive positive-pressure ventilation(NIPPV);;chronic obstructive pulmonary disease(COPD);;respiratory failure;;upper gastrointestinal hemorrhage 中文刊名：CZXX 英文刊名：Journal of Changchun University of Chinese Medicine 机构：吉林大学中日联谊医院;吉林大学第一医院; 出版日期：2019-04-09 出版单位：长春中医药大学学报 年：2019 期：v.35 基金：吉林大学科研项目(2018166) 语种：中文; 页：CZXX201902040 页数：4 CN：02 ISSN：22-1375/R 分类号：137-140

摘要

目的探讨无创性通气治疗慢性阻塞性肺疾病呼吸衰竭患者的临床疗效及上消化道出血因素。方法随机选取我院2013年6月-2016年2月收治的慢性阻塞性肺疾病患者159例,均采用无创性通气治疗,分为对照组与观察组。对照组79例,慢性阻塞性肺疾病呼吸衰竭未并发上消化道出血。观察组80例,慢性阻塞性肺疾病呼吸衰竭并发上消化道出血。采用单因素分析法与Logistic回归分析法分析引发上消化道出血的主要因素,并观察临床疗效。结果单因素检验中,观察组肺性脑病、严重感染、p H≤7.2与对照组比较,差异具有统计学意义(P <0.05),性别、年龄等其它10项变量比较差异无统计学意义(P> 0.05)。多因素检验中,严重感染、p H≤7.2两个变量具有独立作用。治疗有效率为98.1%。结论无创性通气治疗可显著提高慢性阻塞性肺疾病呼吸衰竭患者的临床疗效,严重感染与酸中毒是引发患者上消化道出血的主要因素,临床上应进行深入探究,对症治疗。
        Objective To explore the clinical efficacy and upper gastrointestinal bleeding factors in patients with chronic obstructive pulmonary disease(COPD) and respiratory failure treated by non-invasive ventilation. Methods 159 patients with chronic obstructive pulmonary disease from June 2013 to February 2016 were randomly divided into the experimental group and the control group. All patients were treated with noninvasive positivepressure ventilation. 79 patients in the control group, chronic obstructive pulmonary disease respiratory failure is not complicated with upper gastrointestinal hemorrhage. 80 patients in the experimental group, chronic obstructive pulmonary disease respiratory failure is complicated with upper gastrointestinal hemorrhage. Single factor analysis and Logistic regression were used to analyze the main factors causing upper gastrointestinal hemorrhage and observe the clinical efficacy. Results In the single factor analysis, pulmonary encephalopathy, serious infection and(pH≤7.2)in the experimental group than the control group with statistical difference(P < 0.05). There were no significant differences in gender, age and other 10 variables. In the logistic regression, serious infection and(pH ≤ 7.2) have an independent effect. The effective rate of treatment is 98.1%. Conclusion Non-invasive ventilation therapy can significantly improve the clinical efficacy of patients with chronic obstructive pulmonary disease and respiratory failure. Severe infection and acidosis are the main factors that cause upper gastrointestinal bleeding in patients. Deep exploration should be carried out in clinic, symptomatic treatment.

引文

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