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目的观察无创通气治疗老年晚期肺癌合并呼吸衰竭的疗效。方法选取2010年2月到2013年4月收治的老年晚期肺癌合并呼吸衰竭患者46例,随机分为观察组(23例)和对照组(23例)。对照组患者进行传统治疗,观察组患者在此基础上经口鼻面罩进行无创通气。治疗后2d、1个月和6个月时,比较两组患者临床症状改善情况、生活自理能力以及血气分析指标。结果治疗后2d,观察组患者精神改善、食欲改善、生活自理能力以及血气分析指标均明显优于对照组,差异有统计学意义(P<0.05)。治疗1个月后,观察组患者在精神改善、食欲改善、生活自理能力显著优于对照组,差异有统计学意义(P<0.05),两组患者消化道出血、肺性脑病和死亡情况差异无统计学意义(P>0.05)。治疗6个月后,观察组患者肺性脑病和死亡情况显著低于对照组,差异有统计学意义(P<0.05),电解质紊乱和消化道出血的发生率差异无统计学意义(P>0.05)。结论无创通气治疗老年晚期肺癌合并呼吸衰竭能显著改善患者体征、降低死亡率和肺性脑病发生率,临床疗效显著,值得进一步推广。
Objective To observe the curative effect of noninvasive ventilation in treating elderly patients with advanced lung cancer complicated with respiratory failure. Methods 46 elderly patients with advanced lung cancer and respiratory failure who were admitted from February 2010 to April 2013 were randomly divided into observation group (23 cases) and control group (23 cases). Patients in the control group were treated by conventional therapy. On the basis of this, patients in the observation group received non-invasive ventilation via oral or nasal mask. At 2 days, 1 month and 6 months after treatment, the clinical symptoms, self-care ability and blood gas analysis were compared between the two groups. Results 2 days after treatment, the patients in the observation group had better mental performance, improved appetite, self-care ability and blood gas analysis indexes than the control group (P <0.05). After 1 month of treatment, the patients in the observation group were significantly better than those in the control group in terms of mental improvement, improvement of appetite and life self-care ability (P <0.05). There was no significant difference in gastrointestinal bleeding, pulmonary encephalopathy and death between the two groups No statistical significance (P> 0.05). After 6 months of treatment, the incidence of pulmonary encephalopathy and death in the observation group was significantly lower than that in the control group (P <0.05), and there was no significant difference in the incidence of electrolyte disturbance and gastrointestinal bleeding (P> 0.05 ). Conclusion Non-invasive ventilation in elderly patients with advanced lung cancer combined with respiratory failure can significantly improve the patient’s signs and reduce the incidence of mortality and pulmonary encephalopathy. The clinical efficacy is significant and worthy of further promotion.