长期家庭无创通气对慢性阻塞性肺疾病患者的治疗作用

目的探讨长期家庭无创通气应用于慢性阻塞性肺疾病(COPD)患者稳定期的临床效果。方法选取我院收治的90例COPD急性加重期患者,分为两组,对照组45例患者在出院后采用稳定期一般治疗,试验组45例患者在对照组基础上采用长期家庭无创通气治疗,对患者随访1年并定期电话回访,观察并比较两组患者出院时及出院后1年复诊时呼吸功能、血气分析及睡眠质量。结果两组患者出院时及出院1年FEV1和FVC无显著差异,组间比较也无统计学意义(P>0.05)。试验组和对照组患者出院1年PaCO2分别为(55.23±3.65)mm Hg和(58.32±3.98)mm Hg,两组比较差异无统计学意义(P>0.05)。而两组患者的PO2及pH治疗前后及组间比较差异无统计学意义(P>0.05)。试验组和对照组出院1年睡眠质量PSQI评分分别为(7.20±2.08)分和(9.78±3.01)分,两组比较差异有统计学意义(P<0.05)。结论 COPD患者稳定期在采用长期家庭氧疗的基础上联合使用长期家庭无创正压通气对患者肺功能改善不明显,但可显著改善患者高碳酸血症,提高患者睡眠质量,对降低急性期发作次数及提高患者生活质量有重大意义。

Long-term Domestic Noninvasive Ventilation Function for Chronic Obstructive Pulmonary Disease Treatment

Objective To explore the clinical effects of long-term home noninvasive ventilation on chronic obstructive pulmonary disease(COPD)patients at stable age.Methods 90 cases of COPD patients with acute exacerbations in our hospital were selected and divided into two groups,45 cases in the control group received general treatment at stable stage after discharge,45 cases in the test groupreceived long-term home noninvasive ventilation on the basis of control group treatment.The patients were followed up for 1 year and regular telephone interviews were done,the two groups were observed and compared at discharge and 1 year referral,including the aspects of respiratory function,blood gas analysis and quality of sleep.Results The FEV1 and FVC of the patients of the two groups at discharged time and 1 year later had no significant differences,the difference between the two groups was not significant either(P>0.05).The PaCO2 of the test group and control group 1 year after discharge from hospital were(55.23±3.65)mm Hg and(58.32±3.98)mm Hg,the difference between the two groups was not statistically significant(P>0.05).The PO2 and pH of the two groups before and after treatment and between-group difference were not statistically significant(P>0.05).The sleep quality(PSQI)score of the test group and control group 1 year after discharge was(7.20±2.08)points and(9.78±3.01)points respectively,the difference was statistically significant(P<0.05).Conclusion Long-term home noninvasive positive pressure ventilation based on home oxygen therapy does not have obvious effect on the lung function improvement of COPD patients at stable stage,but can significantly improve hypercapnia and sleep quality,which is of great significance for reducing acute onset number and improve patients’ quality of life.