无创机械通气联合中药对老年慢性阻塞性肺疾病合并II型呼吸衰竭患者的疗效分析

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目的:对无创机械通气联合中药治疗老年慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效及安全性进行观察和评价。方法:选取100例老年COPD合并Ⅱ型呼吸衰竭患者作为研究对象,将其随机分成观察组和对照组,每组各50例。对两组患者均给予抗感染、止咳化痰等对症治疗,对照组患者在此基础上给予双相正压无创机械通气治疗,观察组患者在对照组疗法的基础上联合应用中药进行治疗。对两组患者治疗前、治疗后的动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)的变化情况、血气改善时间、不良反应进行观察和分析。结果:两组患者治疗后的PaO2较治疗前显著提高(P<0.05),PaCO2较治疗前显著降低(P<0.05),且观察组的改善程度大于对照组(P<0.05);两组患者在血气改善时间方面的差异无显著统计学意义(P>0.05);两组患者均未发生呼吸机相关肺部感染、肝肾功能异常等严重不良反应。结论:使用无创机械通气联合中药治疗老年COPD合并II型呼吸衰竭患者的疗效优于单独使用无创机械通气进行治疗,其改善血气指标的作用更加显著,而且安全性较高,值得在临床上推广应用。 Objective: To observe and evaluate the clinical efficacy and safety of noninvasive mechanical ventilation combined with traditional Chinese medicine in the treatment of senile chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure. Methods: A total of 100 elderly patients with COPD and type Ⅱ respiratory failure were selected as study subjects and randomly divided into observation group and control group with 50 cases in each group. The two groups of patients were given anti-infective, cough and phlegm and other symptomatic treatment, patients in the control group were given bipolar positive pressure noninvasive mechanical ventilation on the basis of the control group patients in the control group based on the combination of traditional Chinese medicine for treatment. The changes of PaO2, PaCO2, blood gas, and adverse reactions before and after treatment were observed and analyzed in two groups of patients. Results: PaO2 was significantly increased in both groups (P <0.05), PaCO2 was significantly lower than that before treatment (P <0.05), and the improvement in the observation group was greater than that in the control group (P <0.05) There was no significant difference in the improvement of blood gas time (P> 0.05). No serious adverse reactions such as ventilator-associated lung infection and abnormal liver and kidney function were found in both groups. Conclusion: The efficacy of noninvasive mechanical ventilation combined with traditional Chinese medicine in the treatment of senile COPD with type II respiratory failure is better than that of noninvasive mechanical ventilation alone. The effect of improving noninvasive mechanical ventilation is more significant, and its safety is higher. It is worth to be popularized clinically .
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