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目的观察院外无创呼吸机治疗慢性阻塞性肺疾病(COPD)稳定期的临床疗效。方法选取2010年6月—2014年2月在南阳市第二人民医院进行诊治的COPD稳定期患者67例,采用随机数字表法分为治疗组(n=34)和对照组(n=33)。对照组患者行常规治疗,治疗组患者行常规治疗联合院外无创呼吸机通气治疗。比较两组患者治疗前后血气指标、肺功能指标、心功能指标及急性发作次数、总住院天数、总医疗费用、生活质量评分。结果两组患者治疗前动脉血二氧化碳分压(Pa CO_2)、动脉血氧分压(Pa O_2)比较,差异无统计学意义(P>0.05);治疗组患者治疗后Pa CO_2低于对照组,Pa O_2高于对照组(P<0.05)。两组患者治疗前第1秒用力呼气容积(FEV_1)、FEV_1与用力肺活量(FVC)比值(FEV_1/FVC)比较,差异无统计学意义(P>0.05);治疗组患者治疗后FEV_1、FEV_1/FVC均高于对照组(P<0.05)。两组患者治疗前6分钟步行试验距离(6MWT)、右心室Tei指数比较,差异无统计学意义(P>0.05);治疗组患者治疗后6MWT长于对照组,右心室Tei指数低于对照组(P<0.05)。两组患者治疗前急性发作次数、总住院天数、总医疗费用、生活质量评分比较,差异无统计学意义(P>0.05);治疗组患者治疗后急性发作次数、总住院天数及总医疗费用少于对照组,生活质量评分低于对照组(P<0.05)。结论院外无创呼吸机有助于改善COPD稳定期患者心、肺功能,减少急性发作次数,提高患者生活质量,且总治疗费用较低,是安全有效的治疗方法。
Objective To observe the clinical efficacy of extrahepatic non-invasive ventilator in the treatment of chronic obstructive pulmonary disease (COPD) in stable phase. Methods Sixty-seven patients with stable COPD who were diagnosed and treated in Nanyang Second People’s Hospital from June 2010 to February 2014 were randomly divided into treatment group (n = 34) and control group (n = 33) . Patients in the control group underwent routine treatment. Patients in the treatment group underwent conventional therapy combined with noninvasive ventilator therapy outside the hospital. Blood gas indexes, pulmonary function indexes, cardiac function indexes, number of acute attacks, total hospitalization days, total medical expenses and quality of life scores were compared between the two groups before and after treatment. Results Before treatment, there was no significant difference in PaCO_2 and Pa O_2 between the two groups (P> 0.05). Pa CO_2 in the treatment group was lower than that in the control group, Pa O_2 higher than the control group (P <0.05). FEV_1, FEV_1 / FVC were not significantly different between the two groups before treatment (FEV_1, FVC) (P> 0.05). The FEV_1, FEV_1 / FVC were higher than the control group (P <0.05). There were no significant differences in the 6MWT distance and the Tei index of right ventricle between the two groups before treatment (P> 0.05). The 6MWT in the treatment group was longer than that in the control group and the Tei index in the right ventricle was lower than that in the control group P <0.05). There was no significant difference between the two groups in the number of pre-treatment acute exacerbations, total hospitalization days, total medical expenses, and quality of life scores (P> 0.05). The number of acute attacks, total hospitalization days and total medical expenses In the control group, the quality of life scores were lower than those in the control group (P <0.05). Conclusion Noninvasive ventilator outside hospital helps to improve heart and lung function, reduce the number of acute exacerbations and improve the quality of life of patients with stable COPD, and the total cost of treatment is low, which is safe and effective.