家庭NPPV对重度COPD稳定期患者的疗效和安全性观察

目的观察家庭NPPV治疗重度COPD稳定期并慢性呼吸衰竭患者的疗效和安全性。方法将40例经住院治疗并接受鼻(面)罩NPPV处于稳定期的重度COPD患者动脉血(PaCO2≥55mmHg),出院后分为实验组(常规治疗+NPPV)和对照组(常规治疗)各20例。分别记录治疗前和治疗1年后的动脉血气、肺功能、6MWD、SGRQ评分、急性加重次数、住院次数等指标。结果 1年后实验组PaO2、PaCO2、6MWD、SGRQ评分、每年急性发作次数、住院次数分别为(63.8±4.3)mmHg、(49.6±4.8)mmHg、(213±32)m、(45.8±5.5)分、(2.8±0.5)次/年、(1.1±0.3)次/年,与对照组(56.5±3.5)mmHg、(58.9±3.7)mmHg、(156±27)m、(56.4±5.4)分、(4.9±0.5)次/年、(3.0±0.3)次/年,比较差异均有统计学意义(P<0.01)。1年内实验组死亡1例,对照组死亡2例,两组比较差异无统计学意义(P>0.05)。结论长期家庭NPPV能明显改善缓解期重度COPD合并慢性呼吸衰竭患者的动脉血气,增加运动耐力,提高生活质量,减少急性发作及住院次数,是治疗重度COPD并慢性呼吸衰竭稳定期患者有效的治疗措施。

Efficacy and Safety Observation of Domiciliary Non-Invasive Positive Pressure Ventilation on Patients with Severe Chronic Obstructive Pulmonary Disease in Stable Phase

Objective To observe the efficacy and safety of domiciliary NPPV on patients with severe COPD and chronic respiratory failure in stable phase.Methods 40 cases with severe COPD and （PaCO2≥55mmHg）,received NPPV in hospital,were divided into experiment group and control group after discharged from hospital,and each group with 20 cases.The patients in experiment group were given home NPPV and conventional treatment,the control group patients were given conventional treatment.Before treatment and after one year the observation indicators included arterial blood gas,pulmonary function,6MWD,SGRQ score,the acute exacerbation frequency,in hospital number of times.Result After one year in experiment group PaO2,PaCO2,6 MWD,the SGRQ score,every year acute exacerbation number of times,in hospital number of times respectively were （63.8±4.3）mmHg,（49.6 ±4.8）mmHg,（213±32）m,（45.8±5.5） points,（2.8±0.5） times each year,and （1.1±0.3）times each year,in control group （56.5±3.5）mmHg,（58.9±3.7）mmHg,（156±27）m,（56.4±5.4） points,（4.9±0.5） times each year,and （3.0±0.3） times each year,the difference between the two groups was statistics significance （P 0.01）.One died in experiment group,two died in control group during the first year,the difference between the two groups was not significant （P0.05）.Conclusion The long-tem homes NPPV on patients with severe chronic obstructive pulmonary disease and type II respiratory failure in stable phase were able obviously to improve arterial blood gas,increase movement endurance,improve the life quality,reduce the acute outbreak and in hospital number of times.It might be an effective and safe remedial measure on patients with severe COPD and chronic respiratory failure in stable phase.