不同呼吸兴奋剂联合无创正压通气治疗慢性阻塞性肺病合并呼吸衰竭的临床疗效

摘要

Objective To study clinical effects of different respiratory stimulants combined with non-invasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease ( COPD) with respiratory failure .Methods Eighty cases of COPD complicated with respiratory failure were randomly divided into group A and B , each consisting of 40 cases.The patients of group A were given BiPAP positive pressure ventilation combined with nikethamide , while the patients of group B received BiPAP positive pres-sure ventilation combined with multiple Shaple therapy .Then, blood gas indicators , respiratory data , prognosis and adverse reactions were compared between the groups .Results Following treatment , the partial pressure of oxygen in the patients of group B was signifi-cantly higher than that of group A, and the partial pressure of carbon dioxide was lower than that of group A (P<0.01).The respirato-ry rate and minute ventilation of the patients in Group B were significantly higher than those of the patients in group A (P<0.01).The intubation rate of the patients in group B was higher than that of the patients in group A (P<0.01).There was no statistical signifi-cance in the rate of mortality, when comparisons were made between the 2 groups (P>0.05).Statistical differences could neither be seen in adverse drug reactions, when comparisons were made between the 2 groups(P>0.05).Conclusion Multiple Shaple combined with BiPAP positive pressure ventilation could achieve better clinical effects on COPD with respiratory failure , better safety and reliabili-ty, and it was worth further clinical extension .%目的：考察不同呼吸兴奋剂联合无创正压通气治疗慢性阻塞性肺病（ chronic obstructive pulmonary disease ， COPD）合并呼吸衰竭的临床疗效。方法将80例COPD合并呼吸衰竭患者依据知情同意原则按治疗方法分为A组和B组，每组40例。 A组患者给予双水平正压通气（ Bi－level positive airway pressure ，BiPAP）联合尼可刹米治疗，B组患者给予BiPAP正压通气联合多沙普仑治疗。比较2组患者的血气指标、呼吸情况、转归情况以及不良反应。结果治疗后，B组患者血氧分压显著高于A组（P＜0．01），血二氧化碳分压显著低于A组（P＜0．01）。 B组患者呼吸频率和分钟通气量显著高于A组，差异有统计学意义（P＜0．01），B组患者插管率高于A组（P＜0．01）。2组间死亡率差异无统计意义（P＞0．05）。2组患者不良反应差异无统计学意义（P＞0．05）。结论多沙普仑联合BiPAP治疗COPD合并呼吸衰竭的临床疗效更佳，安全可靠，具有临床应用价值。