轻度镇静联合无创正压通气治疗慢性阻塞性肺疾病急性加重期的疗效观察

目的探讨轻度镇静联合无创正压通气（NPPV）治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效。方法将78例AECOPD患者随机分为观察组（39例）和对照组（39例）。两组NPPV及其他常规治疗相同,观察组在此基础上给予咪达唑仑轻度镇静治疗,目标Ramsay评分为2分。监测并比较两组患者生命体征、血气分析、气管插管率、住院时间及病死率等。结果与对照组比较,观察组治疗后2 h患者心率（HR）、呼吸频率（R）、血压（BP）、动脉血氧饱和度（SaO2）、动脉血氧分压（PaO2）及动脉血二氧化碳分压（PaCO2）明显改善;气管插管率明显降低,住ICU时间和住院时间明显减少,28 d和90 d病死率明显下降。两组间比较差异均有统计学意义（均P〈0.05）。结论轻度镇静可提高AECOPD患者NPPV成功率,减少氧耗,降低气管插管率及病死率,有效改善预后

Effect observation of slight sedation and noninvasive positive pressure ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease

Objective To investigate the effect of slight sedation and noninvasive positive pressure ventilation(NPPV) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 78 patients with AECOPD were randomly divided into observation group(39 patients) and control group(39 patients).Both groups were given same NPPV and other conventional therapy.In addition,the observation group was given Midazolam for achieving Ramsay sedation two score.The vital sign,blood gas analysis,tracheal intubation rate,hospital stays and fatality rate of two groups were monitored and compared.Results In comparation with the control group,the HR,R,BP,SaO2,PaO2 and PaCO2 of observation group improved remarkably in 2 hours after treatment,tracheal intubation rate,hospital stays in ICU,general hospital stays,28 days and 90 days fatality rate lowered obviously.There were significant differences between two groups(P < 0.05).Conclusion Slight sedation can improve NPPV success rate of AECOPD patients,lower oxygen consumption,tracheal intubation rate and fatality rate,improve prognosis effectively.