高压力家庭无创通气对稳定期慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效研究

摘要

Objective:To study the efficacy of high-intensity non-invasive ventilation in stable chronic obstructive pulmonary disease patients with type Ⅱ respiratory failure.Method:36 patients with chronic obstructive pulmonary exacerbation and type Ⅱ respiratory failure in our department from July 2013 to February 2016 were selected,after treatment,the disease was still stable with carbon dioxide retention.According to the random number table method,they were divided into the experimental group and control group,each of 18 cases.Two groups of patients were discharged from hospital at home to continue the use of noninvasive ventilation,the experimental group used the high-inspiratory pressure,the control group used the conventional inspiratory pressure,before and after treatment for 6 months,the FVC,FEV1,PaCO2,PaO2 and dyspnea scores in the two groups were compared.Result:After treatment,the two groups of PaCO2 and PaO2 compared with before treatment, the differences were statistically significant(P<0.05),and the PaO2,PaCO2 of the experimental group compared with control group,the differences were statistically significant(P<0.05),but the FEV1 and FVC of experimental group compared with before treatment and control group,the differences were not statistically significant(P>0.05).After treatment,between the dyspnea score of the two groups compared,there was no significant difference (P>0.05).Conclusion:To stable chronic obstructive pulmonary disease patinets with type Ⅱ respiratory failure home high-intensity non-invasive ventilation can better decrease carbon dioxide retention,but it can’t better improve lung function and exercise power.%目的：研究高压力家庭无创通气对稳定期慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效。方法：选取2013年7月-2016年2月因慢性阻塞性肺急性加重且合并Ⅱ型呼吸衰竭在本科室住院，经治疗后病情平稳仍伴有二氧化碳潴留的患者36例。按照随机数字表法分为试验组和对照组，各18例。两组患者均出院后在家中继续使用无创通气，试验组使用高吸气压力，对照组使用常规吸气压力，比较治疗前与治疗6个月后两组患者的FVC、FEV1、PaCO2、PaO2数值及呼吸困难评分。结果：两组治疗后的PaCO2、PaO2与治疗前比较，差异均有统计学意义（P<0.05）；且试验组治疗后的PaCO2、PaO2与对照组比较，差异均有统计学意义（P<0.05）；而试验组治疗后的FVC、FEV1与治疗前及对照组比较，差异均无统计学意义（P>0.05）；两组治疗后呼吸困难评分比较，差异无统计学意义（P>0.05）。结论：高压力家庭无创通气对稳定期慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的患者降低二氧化碳潴留比低压力效果更好，但两者对肺功能和运动耐力改善无差异。