中西医结合综合疗法治疗老年COPD所致急性呼吸衰竭患者的临床疗效观察

摘要

Objective:To study the clinical effect of combined treatment of traditional Chinese medicine and Western medicine in the treatment of acute respiratory failure in elderly patients with chronic obstructive pulmonary disease ( COPD) . Methods:150 COPD patients with acute respiratory failure caused by COPD in elderly admitted in our hospital from August 2012 to August 2014 were selected, all patients used traditional Chinese medicine and Western medicine combined treatment and were randomly divided into three groups, re-spectively for the noninvasive ventilation group ( noninvasive group) , invasive noninvasive sequential ventila-tion group ( sequential group) and comprehensive treatment group ( fiber bronchoscope sputum suction, atomi-zation treatment and ventilator treatment) , each group with 50 cases, observed effects and complications of the three groups. Results: Before treatment, there were no differences in clinical parameters amony the three groups ( P>0.05) . After treatment, the clinical indicators of the comprehensive treatment group were signifi-cantly better than the other two groups(P<0.05).The time of VAP and PIC, mechanical ventilation and hospi-tal stay in the comprehensive treatment group were better than those in the other two groups(P<0.05).The in-cidence of complications in noninvasive group, sequential group and comprehensive treatment group were 26%, 18% and 8% respectively, and the comprehensive treatment group was significantly lower than the other two groups( P<0.05) . Conclusion:The effect of sequential mechanical ventilation in the treatment of COPD induced acute respiratory failure is better than that of noninvasive ventilation, and traditional Chinese and Western medicine combined treatment effect is the most significant, not only significantly shorten the therapy time and aeration time, fewer complications, but also symptoms improved significantly, it is worth clinical ap-plication and popularization.%目的：：研究老年慢性阻塞性肺疾病( COPD)急性呼吸衰竭患者采用中西医结合综合治疗的临床效果。方法：临床纳入150例我院2012年8月至2014年8月收治的老年COPD致急性呼吸衰竭的患者，将所有患者按入院顺序分为三组，分别为无创通气组(无创组)、有创无创序贯通气组(序贯组)以及综合治疗组(纤维镜吸痰、雾化治疗以及通气机治疗等)，每组各50例，观察三组患者治疗效果、并发症等。结果：治疗前，三组患者各临床指标对比无差异( P>0.05)；治疗后，综合治疗组患者各临床指标水平明显优于其它两组( P<0.05)；综合治疗组VAP 和PIC出现时间、机械通气以及住院时间均优于其它两组( P<0.05)；无创组、序贯组以及综合治疗组并发症发生率分别为28％、18％以及8％，综合治疗组明显低于其它两组(P<0.05)。结论：序贯通气治疗COPD 所致急性呼吸衰竭效果优于无创通气，而中西医结合综合治疗效果最为显著，不仅明显缩短患者治疗时间和通气时间，而且并发症发生少，症状改善显著，值得临床应用及推广。