舒利迭无创通气对慢性阻塞性肺疾病合并呼吸衰竭患者肺功能及动脉血气分析的影响

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目的:探讨舒利迭联合无创通气对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者肺功能和动脉血气的影响。方法:选取2013年5月-2015年5月在我院接受治疗的COPD合并呼吸衰竭患者92例,根据治疗方法不同,将患者分为研究组和对照组。对照组患者给予控制感染、化痰、平喘等常规治疗,研究组在此基础上给予舒利迭无创通气治疗。采用血气分析仪检测两组患者治疗前后二氧化碳分压(PaCO_2)、血氧分压(PaO_2)及酸碱度(pH)等动脉血气指标。应用肺功能检测仪检测患者用力肺活量(FVC)、呼气高峰流量(PEFR)以及1 s用力呼气容积(FEV1)等肺功能指标。结果:治疗前,两组患者PaCO_2,PaO_2,pH,FVC,PEFR及FEV1比较,差异均无统计学意义(P>0.05);治疗后,两组患者PaCO_2较治疗前明显下降,而PaO_2与pH明显上升,差异具有统计学意义(P<0.05);治疗后,研究组PaCO_2低于对照组,而PaO_2与pH高于对照组,差异具有统计学意义(P<0.05);治疗后,两组患者FVC,PEFR及FEV1明显上升,且研究组高于对照组,差异均具有统计学意义(P<0.05)。结论:舒利迭联合无创通气对COPD合并呼吸衰竭患者肺功能及动脉血气具有明显的改善作用,值得临床推广及应用。 Objective: To investigate the effects of seretide combined with noninvasive ventilation on pulmonary function and arterial blood gas in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. Methods: From May 2013 to May 2015, 92 patients with COPD and respiratory failure who were treated in our hospital were divided into study group and control group according to different treatment methods. Patients in the control group were given conventional therapy of infection control, phlegm-resolving and antiasthmatic. On the basis of this, the study group was given the therapy of Seretide noninvasive ventilation. Blood gas analyzer was used to detect arterial blood gas indexes such as PaCO 2, PaO 2 and pH before and after treatment. Pulmonary function tests were performed to detect pulmonary function indexes such as forced vital capacity (FVC), peak expiratory flow (PEFR) and forced expiratory volume (FEV1). Results: There was no significant difference in PaCO_2, PaO_2, pH, FVC, PEFR and FEV1 between the two groups before treatment (P> 0.05). After treatment, PaCO_2 in both groups decreased significantly compared with that before treatment, (P <0.05). After treatment, the PaCO_2 in the study group was lower than that in the control group, while the PaO_2 and pH were higher than those in the control group (P <0.05). After treatment, the two groups The FVC, PEFR and FEV1 were significantly increased in the study group and the difference was statistically significant (P <0.05). Conclusion: Combination of seretide and noninvasive ventilation can significantly improve pulmonary function and arterial blood gas in COPD patients with respiratory failure, which is worthy of clinical promotion and application.
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