急性加重期AECOPD并发呼吸衰竭的临床疗效及安全性分析(1)
[摘要] 目的 分析无创机械通气联合雾化吸入药物治疗AECOPD并发呼吸衰竭的临床疗效。 方法 方便选取该院2015年6月—2018年6月间收治的AECOPD并发呼吸衰竭患者112例，在随机数字表法的分组原则下，分观察组(56例，采用无创机械通气与雾化吸入联合治疗)、对照组(56例，采用无创机械通气治疗)，比较临床疗效、血气指标、VAP发生率。 结果 观察组临床总有效率(96.43%)显著较对照组(75.00%)高(χ2=10.500 0，P=0.001 2<0.05)。观察组SPO2、PaO2、PaCO2分别是(94.89±3.26)%、(39.14±3.16)mmHg、(92.86±5.05)mmHg；对照组分别是(90.06±2.68)%、(43.62±4.28)mmHg、(88.04±3.26)mmHg(t=8.564 6、6.301 6、6.007 6 P<0.01)。观察组VAP发生率(3.57%)显著较对照组(26.79%)低(χ2=11.720 1 P=0.000 6 <0.05)。结论 无创机械通气与雾化吸入联合可有效改善AECOPD并发呼吸衰竭患者病情，提高血氧饱和度，降低VAP发生率，值得借鉴。
[关键词] 无创机械通气；雾化吸入；慢性阻塞性肺疾病急性加重期；呼吸衰竭；临床疗效
[中图分类号] R563.9 [文献标识码] A [文章编号] 1674-0742(2019)01(b)-0041-03
[Abstract] Objective To analyze the clinical efficacy of noninvasive mechanical ventilation combined with aerosol inhalation in the treatment of AECOPD complicated with respiratory failure. Methods A total of 112 patients with AECOPD complicated with respiratory failure were conveniently enrolled in our hospital. The study period was from June 2015 to June 2018. Under the grouping principle of random number table method， the observation group (56 cases， using non-invasive mechanical ventilation and Inhalation combined treatment， control group (56 cases， non-invasive mechanical ventilation treatment)， compare clinical efficacy， blood gas index， VAP incidence. Results The total clinical effective rate (96.43%) of the observation group was significantly higher than that of the control group (75.00%)(χ2=10.500 0，P=0.001 2 <0.05). The observation groups SPO2， PaO2， and PaCO2 were (94.89±3.26)%， (39.14±3.16)mmHg， and (92.86±5.05)mmHg， respectively； the control group were (90.06±2.68)%， (43.62±4.28)mmHg， (88.04±3.26)mmHg (t=8.564 6， 6.301 6， 6.007 6， P<0.01). The incidence of VAP in the observation group (3.57%) was significantly lower than that in the control group (26.79%)(χ2=11.720 1， P=0.000 6 <0.05). Conclusion Non-invasive mechanical ventilation combined with nebulization can effectively improve the condition of patients with AECOPD complicated with respiratory failure， improve blood oxygen saturation and reduce the incidence of VAP. It is worth learning.
[Key words] Non-invasive mechanical ventilation； Aerosol inhalation； Acute exacerbation of chronic obstructive pulmonary disease； Respiratory failure； Clinical efficacy
COPD是一種临床常见病，主要特征是气流受限，病情呈进行性发展，急性加重时会明显增加患者死亡率，目前临床对于AECOPD的治疗主要以抗感染、氧疗、糖皮质激素、支气管扩张剂等保守治疗为主，但是效果一般，具有一定的局限性，机械通气是近年来兴起的一种治疗方法，分有创和无创两种，有创机械通气创伤性较大，患者不易接受，因此无创呼吸通气成为目前临床治疗AECOPD的有效手段，单纯的无创机械通气仍旧不能满足AECOPD患者的治疗需求，往往需要联合其他手段巩固临床疗效[1-2]。鉴于上述研究背景下，该文方便选取2015年6月—2018年6月该院收治的AECOPD并发呼吸衰竭患者112例研究，现报道如下。, 百拇医药(季金森)
[关键词] 无创机械通气；雾化吸入；慢性阻塞性肺疾病急性加重期；呼吸衰竭；临床疗效
[中图分类号] R563.9 [文献标识码] A [文章编号] 1674-0742(2019)01(b)-0041-03
[Abstract] Objective To analyze the clinical efficacy of noninvasive mechanical ventilation combined with aerosol inhalation in the treatment of AECOPD complicated with respiratory failure. Methods A total of 112 patients with AECOPD complicated with respiratory failure were conveniently enrolled in our hospital. The study period was from June 2015 to June 2018. Under the grouping principle of random number table method， the observation group (56 cases， using non-invasive mechanical ventilation and Inhalation combined treatment， control group (56 cases， non-invasive mechanical ventilation treatment)， compare clinical efficacy， blood gas index， VAP incidence. Results The total clinical effective rate (96.43%) of the observation group was significantly higher than that of the control group (75.00%)(χ2=10.500 0，P=0.001 2 <0.05). The observation groups SPO2， PaO2， and PaCO2 were (94.89±3.26)%， (39.14±3.16)mmHg， and (92.86±5.05)mmHg， respectively； the control group were (90.06±2.68)%， (43.62±4.28)mmHg， (88.04±3.26)mmHg (t=8.564 6， 6.301 6， 6.007 6， P<0.01). The incidence of VAP in the observation group (3.57%) was significantly lower than that in the control group (26.79%)(χ2=11.720 1， P=0.000 6 <0.05). Conclusion Non-invasive mechanical ventilation combined with nebulization can effectively improve the condition of patients with AECOPD complicated with respiratory failure， improve blood oxygen saturation and reduce the incidence of VAP. It is worth learning.
[Key words] Non-invasive mechanical ventilation； Aerosol inhalation； Acute exacerbation of chronic obstructive pulmonary disease； Respiratory failure； Clinical efficacy
COPD是一種临床常见病，主要特征是气流受限，病情呈进行性发展，急性加重时会明显增加患者死亡率，目前临床对于AECOPD的治疗主要以抗感染、氧疗、糖皮质激素、支气管扩张剂等保守治疗为主，但是效果一般，具有一定的局限性，机械通气是近年来兴起的一种治疗方法，分有创和无创两种，有创机械通气创伤性较大，患者不易接受，因此无创呼吸通气成为目前临床治疗AECOPD的有效手段，单纯的无创机械通气仍旧不能满足AECOPD患者的治疗需求，往往需要联合其他手段巩固临床疗效[1-2]。鉴于上述研究背景下，该文方便选取2015年6月—2018年6月该院收治的AECOPD并发呼吸衰竭患者112例研究，现报道如下。, 百拇医药(季金森)