持续双水平气道正压通气和间断双水平气道正压通气治疗慢性阻塞性肺疾病急性加重期的临床效果观察

目的对比持续双水平气道正压通气和间断双水平气道正压通气治疗慢阻肺急性加重期(AECOPD)的临床效果。方法将77例老年AE慢阻肺患者按照治疗方法随机分为对照组(n=38)与观察组(n=39),分别采用间断双水平气道正压通气与持续双水平气道正压通气治疗。比较两组临床疗效、治疗前后相关临床指标水平、治疗前后生活质量评分。结果(1)经治疗,观察组临床总有效率为89.74%(35/39),对照组为68.42%(26/38),两组疗效差异具有统计学意义(P0.05);(2)两组患者治疗后临床症状评分、呼吸困难分级、Pa CO_2及肺泡灌洗液中性粒细胞计数水平较治疗前均显著减小(P0.05~0.01),两组患者治疗后FEV1及Pa O_2水平较治疗前均显著增大(P0.05);(3)两组患者治疗后SF-36生活量表各维度(躯体功能、心理功能、社会功能及物质功能)评分均显著高于治疗前(P0.05),且观察组患者治疗后上述各维度评分均显著高于对照组治疗后(P0.05)。结论与间断双水平气道正压通气治疗相比,持续双水平气道正压通气治疗老年AECOPD疗效更显著,更能有效改善患者临床症状及肺部供氧状态与预后状况,应在临床上进行推广。

Clinical observation of continuous dual level positive airway pressure ventilation and intermittent bi-level pos-itive airway pressure ventilation in the treatment of AECOPD patients

Objective To compare the clinical effect of continuous double level positive airway pressure ven -tilation and intermittent bi-level positive airway pressure ventilation in the treatment of AECOPD patients .Methods 77 elderly patients with AECOPD were randomly divided into the control group (n=38) and the observation group (n=39).The patients were treated with intermittent bi-level positive airway pressure ventilation and continuous bi-level positive airway pressure ventilation .Their clinical efficacy , clinical indicators and quality of life were compared be-tween the two groups before and after treatment .Results (1) After treatment, the total effective rate was 89.74%(35/39) in the observation group, and 68.42% in the control group (26/38) (P<0.05).(2) Their clinical symptoms score , respiratory difficulty grading , PaCO2 and alveolar lavage fluid neutrophil count decreased significant-ly, and the levels of FEV1 and PaO2 increased obviously after treatment (P<0.05).(3) SF-36 life scale (physical function, social function and material function ) score was significantly higher than before treatment (P<0.05), and it was obviously higher in the observation group than in the control group (P<0.05).Conclusion Compared with intermittent bi-level positive airway pressure ventilation , continuous double level positive airway pressure ventilation is more effective and can effectively improve the clinical symptoms and pulmonary oxygen condition and prognosis in the treatment of elderly patients with AECOPD , which should be widely promoted in clinic .