NPPV治疗慢性阻塞性肺疾病合并重症呼吸衰竭的临床疗效观察

目的 分析无创正压通气治疗慢性阻塞性肺疾病合并重症呼吸衰竭的临床效果。方法 选择我院2015年3月~2017年4月诊治的慢性阻塞性肺疾病合并重症呼吸衰竭患者86例进行研究，随机分为研究组和对照组，各43例，对照组患者进行常规治疗，研究组在此基础上应用NPPV治疗，对比两组患者的心率、呼吸频率、动脉血气水平、治疗效果和不良反应。结果 研究组患者的心率水平优于对照组[（88.62±1.27）vs（98.37±1.33）]次/min，差异有统计学意义（P＜0.05）；研究组患者呼吸频率低于对照组[（18.24±2.26）vs（27.33±2.71）] 次/min，差异有统计学意义（P＜0.05）；研究组患者PaO2和PaCO2水平均优于对照组，差异有统计学意义（P＜0.05）；研究组治疗总有效率为90.69%，对照组治疗总有效率55.81%，组间比较，差异有统计学意义（P＜0.05）；研究组治疗不良反应率低于对照组，组间比较，差异有统计学意义（P＜0.05）。结论 NPPV在慢性阻塞性肺疾病合并重症呼吸衰竭治疗中发挥了积极的价值，能够改善患者的生理指标，治疗有效率高，不良反应少。

Clinical Efficacy of NPPV in the Treatment of Chronic Obstructive Pulmonary Disease with Severe Respiratory Failure

Abstract:Objective To analyze the clinical effect of non-invasive positive pressure ventilation(NIPPV)in the treatment of chronic obstructive pulmonary disease(COPD)with severe respiratory failure.Methods From March 2015 to April 2017,86 patients with chronic obstructive pulmonary disease complicated with severe respiratory failure were randomly divided into study group and control group,43 cases in each.The patients in the study group were treated with NPPV on the basis of routine therapy,and the patients in the control group were treated with routine therapy.The heart rate,respiratory rate,arterial blood gas level,therapeutic effect and adverse reactions were compared between the two groups.Results The heart rate in the study group was significantly higher than that in the control group [(88.62±1.27)vs(98.37±1.33)]times/min,the difference was statistically significant(P<0.05);the respiratory rate in the study group was lower than that in the control group[(18.24±2.26)vs(27.33±2.71)]times/min,the difference was statistically significant(P< 0.05).The Pao2 and PaCO2 levels in the study group were higher than those in the control group,the difference was statistically significant(P<0.05),the total effective rate in the study group was 90.69% and the total effective rate in the control group was 55.81%,the difference was statistically significant(P<0.05).The adverse reaction rate in the study group was lower than that in the control group, and the difference between the two groups was statistically significant(P<0.05).Conclusion NPPV plays a positive role in the treatment of chronic obstructive pulmonary disease(COPD)with severe respiratory failure. NPPV can improve the physiological index of the patients.The effective rate of NPPV is high and the adverse reaction is less.