氧气驱动雾化吸入联合无创呼吸机治疗COPD合并Ⅱ型呼吸衰竭的临床观察
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摘要
目的探讨氧气驱动雾化吸入联合无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者的临床疗效。方法选取2016年5月至2017年11月期间本院收治的78例COPD合并Ⅱ型呼吸衰竭患者,随机分为对照组和观察组,各39例,对照组给予常规临床治疗,而观察组在对照组的基础上采用氧气驱动雾化吸入联合无创呼吸机治疗。观察并比较两组生命体征和动脉血气指标、肺功能以及临床治疗总有效率。结果治疗后,观察组的心律(HR)、呼吸频率(RR)、动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)和pH等指标均明显优于对照组(P<0.05);观察组1秒用力呼气容积(FEV1)和用力呼气量占用力肺活量比值(FEV1/FVC)改善情况明显较对照组好(P<0.05);对照组和观察组的临床总有效率分别为64.10%和84.62%,观察组明显好于对照组(P<0.05)。结论应用氧气驱动雾化吸入联合无创呼吸机治疗COPD合并Ⅱ型呼吸衰竭患者,可以明显改善心率、呼吸、动脉血气和肺功能,优化疗效,值得在临床推广应用。
Objective To investigate the clinical efficacy of oxygen-driven nebulization inhalation combined with non-invasive ventilator in the treatment of chronic obstructive pulmonary disease(COPD) with type II respiratory failure. Methods 78 COPD patients with type II respiratory failure admitted to our hospital from May 2016 to November 2017 were randomly divided into control group and observation group, 39 cases in each group. The control group was given routine clinical treatment, while the observation group was treated with oxygen-driven atomization inhalation combined with non-invasive ventilator on the basis of the control group. The vital signs, arterial blood gas index, lung function and total effective rate of clinical treatment were observed and compared between the two groups. Results After treatment, the indexes of heart rate(HR), respiratory rate(RR), arterial partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2) and pH in the observation group were significantly better than those in the control group(P<0.05); the improvement of forced expiratory volume(FEV1) and forced expiratory volume occupied forced vital capacity ratio(FEV1/FVC) in the observation group was significantly better than those in the control group(P<0.05). The total clinical effective rates of the observation group were 64.10% and 84.62%, respectively. The observation group was significantly better than the control group(P<0.05). Conclusion Oxygen-driven nebulization inhalation combined with non-invasive ventilator can significantly improve heart rate, respiration, arterial blood gas and pulmonary function in patients with COPD complicated with type II respiratory failure, and optimize the curative effect, which is worthy of clinical application.
Objective To investigate the clinical efficacy of oxygen-driven nebulization inhalation combined with non-invasive ventilator in the treatment of chronic obstructive pulmonary disease(COPD) with type II respiratory failure. Methods 78 COPD patients with type II respiratory failure admitted to our hospital from May 2016 to November 2017 were randomly divided into control group and observation group, 39 cases in each group. The control group was given routine clinical treatment, while the observation group was treated with oxygen-driven atomization inhalation combined with non-invasive ventilator on the basis of the control group. The vital signs, arterial blood gas index, lung function and total effective rate of clinical treatment were observed and compared between the two groups. Results After treatment, the indexes of heart rate(HR), respiratory rate(RR), arterial partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2) and pH in the observation group were significantly better than those in the control group(P<0.05); the improvement of forced expiratory volume(FEV1) and forced expiratory volume occupied forced vital capacity ratio(FEV1/FVC) in the observation group was significantly better than those in the control group(P<0.05). The total clinical effective rates of the observation group were 64.10% and 84.62%, respectively. The observation group was significantly better than the control group(P<0.05). Conclusion Oxygen-driven nebulization inhalation combined with non-invasive ventilator can significantly improve heart rate, respiration, arterial blood gas and pulmonary function in patients with COPD complicated with type II respiratory failure, and optimize the curative effect, which is worthy of clinical application.
引文
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[9]郭文亮,杨峰,郑则广,等.呼吸模式及雾化装置对雾化吸入药物利用率的影响[J].中华结核和呼吸杂志,2016,39(12):980-982.
[10]刘振宽,张宇.无创机械通气联合雾化吸入药物治疗AECOPD并发呼吸衰竭的临床观察[J].中国药房,2016,27(20):2833-2835.
[11]陈英华,张立军.BiPAP无创呼吸机联合呼吸兴奋剂治疗COPD合并Ⅱ型呼衰的疗效观察[J].临床肺科杂志,2015,21(2):297-299.
[12]武玉斌,吴祖凤.不同雾化方式在Ⅱ型呼吸衰竭的疗效观察[J].安徽医药,2015,32(4):806-807.
[13]李改平,刘宇,徐燕杰,等.沙美特罗替卡松粉吸入剂联合无创正压通气治疗老年慢性阻塞性肺疾病合并呼吸衰竭的临床效果[J].中国医药,2017,12(8):1153-1156.
[14]任柏沉,王春茂,孙建,等.无创通气联合雾化吸入对老年慢性阻塞性肺气肿并呼吸衰竭动脉血气及肺功能的影响[J].临床误诊误治,2017,30(6):88-92.
[15]刘印红,张勇,张扬,等.纳洛酮联合无创呼吸机对老年慢性阻塞性肺疾病合并呼吸衰竭患者血气指标、肺功能的影响[J].贵州医药,2016,40(5):486-488.
[16]沈惠峰,张睢扬.异丙托溴铵联合无创呼吸机通气治疗对COPD合并呼吸衰竭患者临床效果研究[J].中华肺部疾病杂志,2017,10(6):673-676.
[17]漆毅,姚檬娜,周畅,等.无创呼吸机间歇正压呼吸疗法治疗老年慢阻肺并发急性呼吸衰竭的疗效观察[J].中国医学装备,2017,14(7):110-114.
[18]杨芸,顾惠芳,朱亚冰,等.无创机械通气联合雾化吸入治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭18例及护理体会[J].中国药业,2015,24(23):169-170.
[19]李亚楠,吴庆建.沙美特罗替卡松气雾剂联合无创正压通气治疗老年慢性阻塞性肺疾病并呼吸衰竭的临床疗效[J].实用心脑肺血管病杂志,2016,24(4):114-117.
[2]文慧兰,况九龙.重叠综合征与炎症、心血管疾病关系的研究进展[J].中国老年学杂志,2016,36(8):2033-2035.
[3]悦云.纤维支气管镜对机械通气治疗COPD并呼吸衰竭的效果及并发症的影响[J].中国急救医学,2015,21(4):355-357.
[4]王聪.不同通气法对COPD合并呼吸衰竭患者的疗效及预后研究[J].陕西医学杂志,2017,46(8):1048-1050.
[5]龚年金.鼻面罩无创正压通气联合呼吸兴奋剂治疗慢性阻塞性肺疾病合并呼吸衰竭及肺性脑病的临床疗效观察[J].实用心脑肺血管病杂志,2015,20(4):23-25.
[6]柳静,李凡.社区卫生服务中心无创机械通气治疗慢性阻塞性肺疾病并发呼吸衰竭的体会[J].中国全科医学,2016,29(5):521-524.
[7]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[8]宋雅君,周新,周哲慧,等.无创正压通气对稳定期合并慢性呼吸衰竭的COPD患者生活质量、肺功能、动脉血气的影响[J].实用临床医药杂志,2015,19(21):185-186.
[9]郭文亮,杨峰,郑则广,等.呼吸模式及雾化装置对雾化吸入药物利用率的影响[J].中华结核和呼吸杂志,2016,39(12):980-982.
[10]刘振宽,张宇.无创机械通气联合雾化吸入药物治疗AECOPD并发呼吸衰竭的临床观察[J].中国药房,2016,27(20):2833-2835.
[11]陈英华,张立军.BiPAP无创呼吸机联合呼吸兴奋剂治疗COPD合并Ⅱ型呼衰的疗效观察[J].临床肺科杂志,2015,21(2):297-299.
[12]武玉斌,吴祖凤.不同雾化方式在Ⅱ型呼吸衰竭的疗效观察[J].安徽医药,2015,32(4):806-807.
[13]李改平,刘宇,徐燕杰,等.沙美特罗替卡松粉吸入剂联合无创正压通气治疗老年慢性阻塞性肺疾病合并呼吸衰竭的临床效果[J].中国医药,2017,12(8):1153-1156.
[14]任柏沉,王春茂,孙建,等.无创通气联合雾化吸入对老年慢性阻塞性肺气肿并呼吸衰竭动脉血气及肺功能的影响[J].临床误诊误治,2017,30(6):88-92.
[15]刘印红,张勇,张扬,等.纳洛酮联合无创呼吸机对老年慢性阻塞性肺疾病合并呼吸衰竭患者血气指标、肺功能的影响[J].贵州医药,2016,40(5):486-488.
[16]沈惠峰,张睢扬.异丙托溴铵联合无创呼吸机通气治疗对COPD合并呼吸衰竭患者临床效果研究[J].中华肺部疾病杂志,2017,10(6):673-676.
[17]漆毅,姚檬娜,周畅,等.无创呼吸机间歇正压呼吸疗法治疗老年慢阻肺并发急性呼吸衰竭的疗效观察[J].中国医学装备,2017,14(7):110-114.
[18]杨芸,顾惠芳,朱亚冰,等.无创机械通气联合雾化吸入治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭18例及护理体会[J].中国药业,2015,24(23):169-170.
[19]李亚楠,吴庆建.沙美特罗替卡松气雾剂联合无创正压通气治疗老年慢性阻塞性肺疾病并呼吸衰竭的临床疗效[J].实用心脑肺血管病杂志,2016,24(4):114-117.