尼克刹米与无创呼吸机对COPD合并呼吸衰竭患者的疗效分析

摘要

目的 探讨尼克刹米联合无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的效果.方法 选取2014年2月~2016年3月于浙江省义乌市中心医院治疗的COPD合并呼吸衰竭患者127例,将患者随机分为观察组(72例)和对照组(55例),对照组给予无创呼吸机治疗,观察组在对照组基础上给予尼克刹米治疗,观察2组治疗疗效、血气指标变化等.结果 观察组治疗有效率为80.56%,明显高于对照组的63.64%,差异有统计学意义(P<0.05);观察组治疗后24h和72 h pH和血氧分压(PaO2)均明显高于对照组,而二氧化碳分压(PaCO2)明显低于对照组,差异有统计学意义(P<0.05);观察组治疗后24h和72 h急性生理和慢性健康评分(APACHEⅡ评分)分别为(20.20±2.71)分和(18.01±1.16)分,明显低于对照组,差异有统计学意义(P<0.05);观察组住院时间、气管插管率和病死率分别为(14.82±4.61)d、11.11%和4.17%,均明显少于对照组,差异有统计学意义(P<0.05).结论无创呼吸机联合尼克刹米治疗COPD合并呼吸衰竭,可改善无创通气效果,降低患者气管插管率.%Objective To investigate the effect of nikethamide combined with noninvasive ventilator in the treatment of chronic obstructive pulmonary disease ( COPD) complicated with respiratory failure.Methods 127 cases with COPD complicated with respiratory failure in our hospital from February 2014 to March 2016 were selected and randomly divided into observation group (72 cases) and control group (55 cases), the control group was treated with noninvasive ventilator therapy, and the observation group was treated with the therapy of nikethamide on the basis of the control group, the therapeutic effect, blood gas changes, etc of two groups were observed.Results The effective rate of the observation group was 80.56%, significantly higher than that of the control group (63.64%), the difference was statistically significant (P<0.05), the observation group after treatment 24h and 72 h pH and oxygen partial pressure (PaO2) were significantly higher than the control group, while the carbon dioxide partial pressure (PaCO2) was significantly lower than the control group, the difference was statistically significant (P<0.05), after treatment 24h and 72 h APACHE II scores in the observation group were (20.20 ±2.71) and (18.01 ±1.16), significantly lower than that of the control group, the difference was statistically significant (P<0.05), the hospitalization time, tracheal intubation rate and mortality rate of the observation group were (14.82 ±4.61) d, 11.11%and 4.17%, which were significantly less than those in the control group, the difference was statistically significant ( P <0.05 ) . Conclusion Noninvasive ventilator combined with nikethamide in the treatment of COPD combined with respiratory failure , can improve the effect of noninvasive ventilation, reduce the rate of tracheal intubation in patients.