无创正压通气联合氧气驱动雾化吸入治疗COPD合并呼吸衰竭患者的临床疗效观察

目的观察无创正压通气联合氧气驱动雾化吸入在慢性阻塞性肺疾病（COPD）合并呼吸衰竭的临床疗效。方法60例COPD呼吸衰竭患者随机分为实验组和对照组各30例，实验组采用无创正压通气联合氧气驱动雾化吸入治疗；对照组采用无创正压通气联合常规雾化吸入常规治疗。观察两组患者的生命体征、血气分析指标、肺功能指标和并发症发生情况。结果实验组和对照组治疗后心率（HR）、呼吸频率（RR）、血二氧化碳分压（PaCO2）和呼吸困难指数均低于治疗前，差异均有统计学意义（均P＜0．05）；实验组治疗后HR、RR、PaCO2和呼吸困难指数均低于对照组，差异均有统计学意义（均P＜0．05）；实验组和对照组动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）、肺功能第1S用力呼吸容积与预计值的比值（FEV。％）、FEV。与用力肺活量（FVCC）的比值（FEV1／FVc）均高于治疗前，差异均有统计学意义（均P＜O．05）；实验组治疗后PaO2、SaO2、FEV，％、FEV。及FEV1／FVC均高于对照组，差异均有统计学意义（均P＜O．05）。治疗期间，实验组排痰困难发生率为3．33％，口感咽痛发生率为6．67％，均低于对照组，差异均有统计学意义（均P＜0．05）。结论对COPD合并呼吸衰竭患者使用无创正压通气联合氧气驱动雾化吸入治疗，可提高疗效，减少治疗并发症，值得临床进行推广应用。

Clinical effects and nursing of noninvasive positive pressure ventilation combined with oxygen driven inhalation of in COPD and respiratory failure

Objective To study on the effects and the nursing measures of noninvasive positive pressure ventilation with oxygen drive atomization inhalation in chronic obstructive pulmonary disease （COPD） and respiratory failure. Methods 60 patients with COPD and respiratory failure were randomly divided into experimental group and control group. The experimental group was treated with noninvasive positive pressure ventilation with oxygen driven inhalation therapy. The control group was treated with noninvasive positive pressure ventilation combined with conventional nebulization therapy. The life boost, blood gas analysis, pulmonary function and complications were observed. Results After treatment, heart rate （HR）, respiratory rate （RR）, partial pressure of carbon dioxide （PaCOz） and dyspnea index on the experimental group and control group were lower than that before treatment, and the differences were statistically significant （P〈0.05） ; after treatment, the HR, RR, PaCO2 and dyspnea index on the experimental group thewere lower than the control group after treatment, and the differences were statistically significant （P〈0. 05） ; After treatment, the arterial partial pressure of oxygen （PaO2）, arterial oxygen saturation （SaO2） ratio of lung function first s force respiratory volume and the predicted value （FEV1%）, FEV1 and forced vital capacity ratio （FEV1/FVC） on the experimental group and the control group the were higher than that before treatment, the differeneeswere statistically significant （P〈0.05） PaO2 , SaO2 , FEV1%, FEV1 and FEV1/FVC on the experimental group were higher than those of the control group after treatment, the differences were statistically significant （P〈0.05） ; during the treatment, expectoration difficulties occurred rate of the experimental group was 3.33%, sore throat, taste the incidence rate was 6.67 ~, lower than the control group, the differences were statistically significant （P〈0.05）. Conclusion Noninvasive positive pressure ve