无创通气治疗慢性阻塞性肺疾病急性加重期50例报告

目的报告无创通气对慢性阻塞性肺疾病急性加重期(AECOPD)患者血气指标及呼吸困难症状的改善效果。方法2013年1至6月间AECOPD病例50例列入对照组,给予常规治疗,包括抗生素、糖皮质激素、祛痰平喘类用药、经鼻导管低流量给氧等治疗,2013年7至12月间AECOPD患者50例列入研究组,加用无创通气治疗。结果两组患者治疗前PaO2和PaCO2比较差异无统计学意义(P>0.05),治疗后均有明显改善,治疗后研究组患者PaO2明显高于对照组,PaCO2明显低于对照组,两组间数据比较差异具有统计学意义(P<0.01)。研究组治疗后12、24、48和72 h时呼吸困难症状缓解比例分别为4.00%、64.0%、72.0%和96.0%,对照组分别为16.0%、28.0%、48.0%和56.0%,两组数据间比较差异具有统计学意义(P<0.05)。结论采用无创通气治疗AECOPD可有效改善患者动脉血气指标,缓解呼吸困难症状,且治疗无创易被患者接受。

Report of 50 Cases of Non-invasive Ventilation Treatment of Chronic Obstructive Pulmonary Disease in Acute Exacerbation

Objective To report the blood gas results and improved dyspnea symptoms of non-invasive ventilation in patients with chronic obstructive pulmonary disease in acute exacerbation （AECOPD）. Methods 50 cases of AECOPD patients from January to June 2013 were selected as the control group, and they were given with conventional treatment, including antibiotics, corticosteroids, expectorant asthma medication class, and low-flow oxygen via nasal carmula therapy; 50 cases of AECOPD patients from July to December 2013 were selected as the study group, and they received non-invasive ventilation therapy in addition. Results The difference of PaO2 and PaCO2 of the two groups before treatment was not statistically significant （P 〉0.05）. But they were significantly improved after treatment. PaO2 of the study group after treatment was significantly higher than that of the control group. PaCO2 was significantly lower than that of the control group. The difference between the two groups was statistically significant （P 〈0.01）. 40.0%, 64.0%, 72.0% and 96.0% of the study group had better dyspnea symptoms in 12, 24, 48 and 72 h after treatment, significantly better than those of the control group （16.0%, 28.0%, 48.0% and 56.0%, respectively） （P 〈0.05）. Conclusions The treatment of non-invasive ventilation which is easier to receive for patients with AECOPD can improve arterial blood gas index, and relieve dyspnea.