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目的 :探讨双水平无创正压通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭的临床疗效。方法将我院收治的AECOPD合并呼吸衰竭患者68例随机分为研究组和对照组,各34例。对照组给予抗炎、解痉、吸氧等常规治疗,研究组常规治疗的基础上实施双水平无创正压通气治疗。观察两组治疗前、治疗后3h及出院时血气分析指标、心率、呼吸频率、血压等变化及患者疾病转归情况。结果 1治疗前两组p H、Pa O2、Pa CO2比较无统计学差异(P>0.05),治疗3h后,研究组患者p H、Pa O2、Pa CO2较治疗前明显改善(P<0.05);对照组患者上述指标无明显(P>0.05)。2治疗前两组心率、呼吸、收缩压均高于正常,两组比较无统计学差异(P>0.05),研究组在治疗3h后心率、呼吸频率和收缩压明显降低(P<0.05),对照组治疗3h后心率、呼吸频率和收缩压无明显变化(P>0.05)。3对照组治疗3h后心率、呼吸频率和收缩压无明显变化(P>0.05)。结论对于AECOPD合并呼吸衰竭患者,双水平无创正压通气可以显著改善患者的临床症状,纠正血气分析指标,是一种有效的治疗方法。
Objective: To investigate the clinical effect of double-level noninvasive positive pressure ventilation in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with respiratory failure. Methods Sixty-eight patients with AECOPD complicated with respiratory failure admitted to our hospital were randomly divided into study group and control group, with 34 cases in each group. The control group was given anti-inflammatory, antispasmodic, oxygen and other conventional treatment, the study group based on the conventional treatment of non-invasive double-level positive pressure ventilation therapy. The changes of blood gas analysis indexes, heart rate, respiration rate, blood pressure, etc. before treatment, 3h after treatment and discharge from hospital were analyzed. Results There was no significant difference in p H, Pa O2 and Pa CO2 between the two groups before treatment (P> 0.05). After 3 hours of treatment, the levels of p H, Pa O2 and Pa CO2 in the study group were significantly improved (P 0.05) There was no significant difference between the control group and the control group (P> 0.05). Heart rate, respiration rate and systolic blood pressure in the two groups before treatment were all higher than those in the normal group (P <0.05) Heart rate, respiratory rate and systolic pressure had no significant changes in the control group after 3 hours of treatment (P> 0.05). Heart rate, respiratory rate and systolic blood pressure did not change significantly in control group 3h after treatment (P> 0.05). Conclusion For patients with AECOPD complicated with respiratory failure, bi-level noninvasive positive pressure ventilation can significantly improve the clinical symptoms of patients and correct blood gas analysis indicators, which is an effective treatment.