摘要
目的探讨无创机械通气治疗慢性阻塞性肺病(COPD)合并意识障碍Ⅱ型呼吸衰竭的临床效果及安全性。方法选取收治的COPD合并意识障碍Ⅱ型呼吸衰竭患者70例,将其分为观察组与对照组,每组35例。对照组给予常规治疗,观察组在常规治疗的基础上给予无创机械通气治疗。观察两组的临床效果、PH值、心率、呼吸频率、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)及并发症情况。结果两组治疗前PH、心率、呼吸频率、PaO2、PaCO2比较差异均无统计学意义(P>0.05);与治疗前比较,两组治疗后PaO2与PH值明显提高,心率、呼吸频率与PaCO2明显下降,差异有统计学意义(P<0.05);与对照组比较,观察组PaO2与PH值提高更显著,心率、呼吸频率与PaCO2下降更显著(P<0.05)。观察组治疗后临床有效率为85.71%,明显高于对照组的62.76%,差异有统计学意义(P<0.05);观察组有1例停用无创呼吸机,2例转为有创呼吸机辅助通气;对照组9例转为有创呼吸机辅助通气,3例治疗无效死亡。结论无创机械通气治疗COPD合并意识障碍Ⅱ型呼吸衰竭的临床效果显著、安全可靠,能有效改善患者血气情况,降低并发症的发生。
Objective To investigate the clinical effect and safety of the noninvasive positive pressure ventilation on chronic obstructive pulmonary disease with consciousness disorders and type Ⅱ respiratory failure. Methods 70 patients of chronic obstructive pulmonary disease （COPD） with consciousness disorders and type Ⅱrespiratory failure were re- ceived from January 2013 to January 2015 in our hospital. They divided into observation group and control group, each group with 35 patients. The clinical effect, PH value, heart rate, breathing rate, arterial blood oxygen partial pressure, arterial blood （PaO2） CO2 partial pressure （PaCO2） and its complications were observed. Results Before treatment, the PH, heart rate, breathing rate, PaO2, PaCO2 comparative differences had no statistical significance in the two group （P〉0.05）. Compared with that before treatment, PaO2 and PH value significantly increased after treatment, heart rate, breathing rate and PaCO2 obviously decreased after treatment （P〈0.05）. Compared with that the control group, PaO2 and PH of observation group prominently increased, the heart rate, breathing rate and PaCO2 of observation significantly decreased （P〈0. 05）. The clinical effective rate of observation group and control group were 85.71% and 62.76% （P〈 0.05）. Conclusion For the patients of COPD with consciousness disorders and type Ⅱ respiratory failure, the noninva- sive positive pressure ventilation had obvious effects, which can effectively improve blood gas condition, reduce the occur- rence of complications and had satisfactory feasibility and security.
出处
《西部医学》
2016年第1期80-83,共4页
Medical Journal of West China
基金
四川省科技厅科研项目(2010FZ0102)
关键词
无创机械通气
慢性阻塞性肺病
意识障碍
呼吸衰竭
Noninvasive mechanical ventilation
Chronic obstructive pulmonary disease
Consciousness disorder
Respiratory failure
