摘要
目的:探究双水平气道正压通气(BiPAP)无创呼吸机联合噻托溴铵对急性加重期慢性阻塞性肺疾病(AECOPD)伴呼吸衰竭(呼衰)患者呼吸强度及肺功能的影响。方法:选取2020年10月—2022年9月瑞金市人民医院急诊科收治的AECOPD伴呼衰患者68例,随机分为对照组和观察组,各34例。对照组予以单独Bi PAP无创呼吸机治疗,观察组在对照组的基础上加用噻托溴铵,均治疗10 d。评价两组的治疗效果及不良反应发生情况,比较两组治疗前、治疗10 d后血气、呼吸动力学及肺功能指标。结果:观察组治疗总有效率高于对照组,差异有统计学意义(88.24%vs 67.65%)(P<0.05)。治疗10 d后,观察组动脉血氧分压(PaO_(2))、氧合指标(PaO_(2)/FiO_(2))、动脉血氧饱和度(SaO_(2))、吸气峰值压(PIP)、第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、最高呼气流速(PEF)及最大呼气中段流量(MMEF)均高于对照组,其动脉血二氧化碳分压(PaCO_(2))、平台压(Pplat)、平均气道压(MPaw)及气道阻力(Raw)均低于对照组,差异均有统计学意义(P<0.05)。对照组和观察组不良反应发生率分别为5.88%和11.76%,差异无统计学意义(P>0.05)。结论:BiPAP无创呼吸机联合噻托溴铵治疗可有效改善AECOPD伴呼衰患者呼吸强度,且能够改善患者肺功能,调节血氧水平,有效且安全。
Objective:To explore the effects of bilevel positive airway pressure(BiPAP)noninvasive ventilator combined with Tiotropium Bromide on respiratory intensity and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and respiratory failure.Method:A total of 68 AECOPD patients with respiratory failure admitted to Emergency Department,Ruijin People's Hospital from October 2020 to September 2022 were selected and randomly divided into control group and observation group,with 34 patients in each group.The patients in the control group were treated with BiPAP noninvasive ventilator,and the patients in the observation group were treated with Tiotropium Bromide on the basis of the control group,both groups were treated for 10 days.The therapeutic effect and incidence of adverse reactions of the two groups were evaluated,and blood gas,respiratory dynamics and lung function indexes between the two groups before and 10 days after treatment were compared.Result:The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(88.24%vs 67.65%)(P<0.05).After 10 days of treatment,partial pressure of arterial oxygen(PaO_(2)),oxygenation index(PaO_(2)/FiO_(2)),arterial oxygen saturation(SaO_(2)),peak inspiratory pressure(PIP),forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),peak expiratory flow(PEF)and maximal mid-expiratory flow(MMEF)in the observation group were higher than those in the control group,and partial pressure of carbon dioxide(PaCO_(2)),plateau pressure(Pplat),mean airway pressure(MPaw)and airway resistance(Raw)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the control group and observation group were 5.88%and 11.76%,respectively,the difference was not statistically significant(P>0.05).Conclusion:BiPAP noninvasive ventilator combined with Tiotropium Bromide treatment can effectively improve the respiratory intensity of AECOPD patients with respiratory failure,improve the lung function of patients,regulate the blood oxygen level,and is effective and safe.
作者
周春晴
邹汶
杨哲
ZHOU Chunqing;ZOU Wen;YANG Zhe(Emergency Department,Ruijin People's Hospital,Ruijin 342500,China;不详)
出处
《中国医学创新》
CAS
2024年第12期26-30,共5页
Medical Innovation of China
关键词
慢性阻塞性肺疾病急性加重期
呼吸衰竭
双水平气道正压通气
无创呼吸机
噻托溴铵
Acute exacerbation of chronic obstructive pulmonary disease
Respiratory failure
Bilevel positive airway pressure ventilation
Noninvasive ventilator
Tiotropium Bromide
作者简介
通信作者:周春晴。
