无创正压通气治疗在COPD急性发作患者中的应用探究

目的 探讨无创正压通气治疗在慢性阻塞性肺疾病（COPD）急性发作患者中的应用效果.方法 收集2010～2012年乐清市地区COPD患者病例资料,并记录急性发作时无创正压通气具体使用情况,并观察随访1年.另选取笔者医院2010年1月～2012年1月之间收治的COPD急性发作患者84例进行研究,按照随机数字表法划分为观察组和对照组各42例,对照组患者给予常规治疗,观察组患者在常规治疗的基础上加用无创正压通气进行治疗,对两组患者的治疗效果进行观察和对比分析.结果 本次研究调查2010 ～ 2012年乐清市地区COPD急性发作患者531例,其中有47例使用NIPPV,NIPPV使用率为8.9％.观察组患者在在平均住院时间、插管率和病死率方面较对照组较低,差异具有统计学意义（P＜0.05）;两组患者治疗后较治疗前,在pH、PaCO2、PaO2值方面均显著改善,且观察组改善效果显著优于对照组,差异具有统计学意义（P＜0.05）.结论 无创正压通气（NIPPV）在乐清地区使用率较低,在采用常规治疗的基础上,采用无创正压通气技术对COPD急性发作患者进行治疗,具有显著的临床效果,值得在临床推广应用.

Clinical Investigation of Noninvasive Ventilation in the Treatment of Acute Exacerbation of COPD

Objective To study clinical apptication of noninvasive positive pressure ventilation （NIPPV）.Methods We collected 2010-2012 Yueqing COPD patients with clinical data and recorded noninvasive positive pressure ventilation in the acute attack specific use,and observed the follow-up of 1 year.Eighty four patients with acute exacerbation of COPD in our hospital from January 2010 to January 2012 were treated for study.In accordance with the principle of randomization,cases was divided into observation group and control group,42 cases in each group.The control group were treated with conventional therapy.The patients in the conventional treatment was based on the use of noninvasive positive pressure ventilation for treatment.The therapeutic effect of two groups of patients were observed and analyzed.Results Totally 531 cases of 2010-2012 Yueqing COPD patients with acute exacerbation were investigated in the study,including 47 cases using NIPPV.The patients in the average length of stay,intubation and mortality rate were lower than the control group （P ＜ 0.05） ; groups of patients after treatment than before treatment,at PH,PaCO2,PaO2 values were significantly improved,and the effect was significantly improved in the observation group than the control group （P ＞ 0.05）.Conclusion NIPPV usage in Yueqing is low,based on the conventional treatment,the use of noninvasive positive pressure ventilation technology to treat patients with acute exacerbation of COPD has significant clinical effect,which is carried out in the clinical application.