无创呼吸机治疗慢阻肺急性加重的临床应用研究

目的：研究无创呼吸机治疗慢阻肺急性加重的可行性。方法方便选取该院2014年8月—2016年2月收治的83例慢阻肺急性加重患者。患者分组方法编号单双数方法。83例患者分为内科治疗组和呼吸机组两个组别。内科治疗组给予内科常规治疗；呼吸机组在内科治疗组基础上增加无创呼吸机治疗。对比两组：①临床干预效果；②需转为有创呼吸机治疗人数；③抗生素用药时间、住院天数；④治疗前和治疗后患者血氧饱和度、动脉二氧化碳分压、血氧分压的差异。结果①呼吸机组相比于内科治疗组临床干预效果更高,其中,内科治疗组总有效率为75.61%,呼吸机组总有效率为95.24%,P﹤0.05；②呼吸机组相比于内科治疗组转为有创呼吸机治疗人数更少,其中,内科治疗组为13例,呼吸机组为3例,P﹤0.05；③呼吸机组相比于内科治疗组抗生素用药时间、住院天数更短,其中,内科治疗组分别为(15.39±2.77)、(22.39±3.57)d,呼吸机组分别为(9.51±2.41)d和(13.51±2.61)d,P﹤0.05；④治疗前两组血氧饱和度、动脉二氧化碳分压、血氧分压相似,P﹥0.05；治疗后呼吸机组相比于内科治疗组血氧饱和度、动脉二氧化碳分压、血氧分压改善更显著,其中,呼吸机组分别为(62.18±10.71) mmHg、(54.22±10.59) mmHg、(95.58±4.26)%；内科治疗组分别为(55.43±9.29) mmHg、(64.11±11.94) mmHg、(85.28±12.12)%,P﹤0.05。结论无创吸机治疗慢阻肺急性加重的可行性高,可有效改善患者血气指标,需转为行有创通气患者人数更少,可缩短抗生素使用时间,加速患者康复出院,对减轻其住院负担意义重大,值得推广。

Noninvasive Ventilator in the Treatment of Copd Exacerbations Clinical Application Research

Objective To study the noninvasive ventilator feasibility for the treatment of copd exacerbations. Methods Con-venient selection from August 2014 to February 2016 were 83 cases of patients with copd exacerbations. Grouping method:patients with Numbers and odd number method. 83 patients were divided into internal medicine treatment group and breathing unit two groups. Medical treatment group given medical conventional treatment; Breathing unit on the basis of medical treatment group increased noninvasive ventilator therapy. Compared two groups ①Effects of clinical interventions;②The need to shift to the invasive ventilation in the treatment of number; ③Antibiotic medication time, length of hospital stay; ④Before treatment and after treatment in patients with blood oxygen saturation, arterial carbon dioxide partial pres-sure, oxygen partial pressure difference.Results ①compared to the Department of internal medicine treatment group, the clinical intervention effect is higher, among them, the total effective rate of the treatment group is 75.61%, the total effective rate is 95.24%, P< 0.05; ②respiratory units compared to the Department of internal medicine treatment group to invasive ventilator fewer, the Department of internal medicine treatment group of 13 cases, 3 cases of respiratory unit, P< 0.05; ③respiratory units compared to the Department of internal medicine treatment group of antibiotics and hospitalization time is shorter, the Department of internal medicine treatment group were(15.39±2.77)days, (22.39±3.57)days, respiratory unit were (9.51±2.41)days and (13.51±2.61)days, P<0.05;④the two groups before treatment, blood oxygen saturation, arterial PCO2, PO2, P> 0.05; after treatment of respiratory units compared to the Department of internal medicine treatment group, arterial oxygen saturation the partial pressure of carbon dioxide, oxygen pressure is more significantly improved, the respiratory unit were (62.18±10.71) mmHg, (54.22±10.59) mmHg, (95.58±4.26)%;Department of internal medicine treatment group were (55.43±9.29) and (64.11±11.94) mmHg, (85.28±12.12)%, P< 0.05.Conclusion Noninvasive suction machine treatment the feasibility of acute exacerbation of copd is high, which can effectively improve the patients' blood gas index, need to do the number of patients with invasive ventilation, less time of antibiotic use, accelerate rehabilitation hospital patients, is of great significance to reduce the burden of the hospital, is worth promoting.