不同治疗方法对晚期慢性阻塞性肺疾病呼吸衰竭患者预后的影响

目的探讨晚期慢性阻塞性肺疾病(COPD)患者临床缓解期最佳的治疗方法。方法将47例晚期COPD患者分为三组:A组为不能或不接受家庭氧疗和家庭无创正压通气(NPPV)者;B组为出院后在医生指导下进行长期家庭氧疗者;C组为能在医生指导下进行长期家庭NPPV加长期家庭氧疗,且能很好耐受者。回顾性对比分析三组患者1年内再住院率、再插管率及病死率。结果B组患者1年内的再住院率、再插管率及病死率较A组分别降低了38.4%、17.3%和18.0%,而C组患者较B组患者又降低了8.0%、35.3%和29.4%,三组患者的再住院率、再插管率及病死率比较,差异均有统计学意义(P<0.05)。结论长期家庭氧疗和长期家庭NPPV能显著降低晚期COPD患者的再住院率、再插管率和病死率,长期家庭氧疗加长期家庭NPPV治疗效果最好。

The effects of different therapies to prognosis of chronic obstructive pulmonary disease complicated by respiratory failure

Objective To study the best therapy of clinical catabasis in patients at advanced stage of chronic obstructive pulmonary disease(COPD). Method Forty-seven patients with COPD at advanced stage were divided into three groups,A group was the patients who couldn't or didn't receive domiciliary oxygen therapy and domiciliary non-invasive positive pressure ventilation (NPPV),B group was those who received long-term domiciliary oxygen therapy,C group was those who received long-term domiciliary oxygen therapy plus long-term domiciliary NPPV. Readmission rate,reintubation rate and mortality after one year were compared. Results The readmission rate,reintubation rate and mortality of B group lowered 38.4%,17.3% and 18.0% respectively,compared to A group. While,the readmission rate,reintubation rate and mortality of C group lowered 8.0%,35.3% and 29.4% respectively,compared to B group. There was significant discrepancy in readmission rate,reintubation rate and mortality among the three groups (P<0.05). Conclusion Long-term domiciliary oxygen therapy and long-term domiciliary NPPV can lower readmission rate,reintubation rate and mortality of patient with COPD at advanced stage. Long-term domiciliary oxygen therapy plus long-term domiciliary NPPV is the best therapy.