无创呼吸机在慢性阻塞性肺疾病合并呼吸衰竭患者中的应用效果及对炎症因子的影响

目的 观察无创呼吸机在慢性阻塞性肺疾病合并呼吸衰竭患者中的临床治疗效果及对炎症因子的影响.方法 取2014年12月至2016年10月本院收治的慢性阻塞性肺疾病合并呼吸衰竭患者60例,采用随机数字方法分为对照组(n=30)和观察组(n=30).对照组采用常规方法治疗,观察组在对照组基础上联合无创呼吸机通气治疗.采用酶联免疫吸附试验检测2组IL-6及肿瘤坏死因子-α,采用免疫比浊法测定2组治疗前后CRP水平,比较2组临床治疗效果及对炎症因子的影响.结果 观察组治疗7d后mMRC评分、辅助呼吸机动用评分低于对照组(P＜0.05);观察组症状改善时间及住院时间短于对照组(P＜0.05);2组治疗前IL-6、肿瘤坏死因子-α及CRP水平比较差异无统计学意义(P＞0.05),观察组治疗后IL-6、肿瘤坏死因子-α及CRP水平低于对照组(P＜0.05);2组治疗前pH、PaCO2及PaO2水平比较差异无统计学意义(P＞0.05),观察组治疗后pH、PaO2水平高于对照组(P＜0.05),观察组治疗后PaCO2水平低于对照组(P＜0.05);观察组治疗期间不良反应发生率为6.67％,对照组为20.00％,观察组不良反应发生率低于对照组(P＜0.05).结论 慢性阻塞性肺疾病合并呼吸衰竭患者在常规治疗基础上联合无创呼吸机治疗效果理想,能提高临床治疗效果,降低炎症因子水平,值得推广应用.

Application of noninvasive ventilator in patients with chronic obstructive pulmonary disease complicated with respiratory failure and its influence on inflammatory factors

Objective To observe the clinical effect of noninvasive ventilator in patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure and its influence on inflammatory factors.Methods From December 2014 to October 2016,60 patients with COPD complicated with respiratory failure were randomly divided into control group (n=30) and observation group (n=30).The control group was treated with conventional methods,and the observation group was treated with non-invasive ventilator ventilation on the basis of the control group.IL-6 and TNF-α were detected by enzyme-linked immunosorbent assay,and CRP was detected by immunoturbidimetry.Compared clinical treatment effect and the impact on inflammatory factors of the two groups.Results The scores of mMRC and MVV in the observation group were lower than those in the control group 7 d after treatment (P＜0.05).The time of symptoms improvement and the length of stay in the observation group were shorter than those in the control group (P＜0.05).There were no statistically significant differences in the levels of IL-6,TNF-α,and CRP between the two groups be.fore treatment (P＞0.05);the levels of IL-6,TNF-α,and CRP in the observation group were lower than those in the control group 7 d after treatment (P＜0.05).There were no statistically significant differences in the levels ofpH,PaCO2,and PaO2 between the two groups before treatment (P＞0.05);7 d after treatment,the levels of pH and PaO2 in the observation group were higher than those in the control group (P＜0.05),the level of PaCO2 in the observation group was lower than that in the control group (P＜0.05).The rate of adverse reactions in the observation group was lower than that in the control group (6.67％ vs.20.00％,P＜0.05).Conclusion The combination of non-invasive ventilator in patients with chronic obstructive pulmonary disease and respiratory failure can improve the clinical therapeutic effect and reduce the levels of inflammatory factors,worthy of popularization and application.