无创呼吸机治疗CPD并发Ⅱ型呼吸衰竭42例分析.docVIP

无创呼吸机治疗COPD并发Ⅱ型呼吸衰竭42例分析 　　摘 要 目的：观察无创呼吸机治疗慢性阻塞性肺疾病（COPD）并发Ⅱ型呼吸衰竭的临床疗效。方法：选取COPD并发Ⅱ型呼吸衰竭患者84例随机分为观察组和对照组各42例。两组患者均给予常规对症支持治疗，观察组在常规治疗的基础上给予无创呼吸机治疗。比较两组患者临床疗效，治疗前后临床症状及体征、HR、RR、血气分析结果、治疗3 d后IL-8、IL-13、IL-18水平以及治疗后插管率、死亡率、住院天数、医疗费用。结果：观察组总有效率高于对照组（P中国论文网 /6/viewhtm　　关键词 无创呼吸机 慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 　　中图分类号：R459.9； R563.8 文献标识码：B 文章编号：1006-1533（2015）23-0052-03 　　Analysis of non-invasive ventilation in the treatment of 42 cases of patients with COPD complicated with type Ⅱ respiratory failure* 　　FAN Jialiang**， PENG Ting 　　（Department of Respiratory Medicine， The Center Peoples’ hospital of Ji’an City， Ji’an 343000， China） 　　ABSTRACT Objective： To observe the clinical effect of non-invasive ventilation in the treatment of chronic obstructive pulmonary disease （COPD） complicated with type II respiratory failure. Methods： Eighty-four cases of patients with COPD complicated with type II respiratory failure were randomly divided into an observation group and a control group with 42 cases each. All the patients were treated by conventional symptomatic treatment， and in additional， the observation group underwent noninvasive ventilation treatment. The clinical curative effect， clinical symptoms and signs， HR， RR， gas analysis results before and after treatment were compared between two groups， as well as the IL-8， IL-13， IL-18 levels and intubation rate， mortality， length of hospital stay， medical expenses 3 days after treatment. Results： The total effective rate was significantly higher in the observation group than in the control group （P0.05）. Conclusion： The curative effect of non-invasive ventilation in the treatment of COPD complicated with type II respiratory failure was significant. 　　KEY WORDS non-invasive ventilation； COPD； type Ⅱ respiratory failure 　　慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是一种具有气流阻塞特征的慢性支气管炎和（或）肺气肿，可进一步发展为肺心病和呼吸衰竭[1]。因COPD患者病情反复发作，其肺功能呈进行性减退，当病情出现急性加重时常可并发Ⅱ型呼吸衰竭。临床上治疗COPD并发Ⅱ型呼吸衰竭患者往往采用气管插管机械通气，该方法虽疗效好，但患者痛苦大、并发症多、费用较高。随着近年来无创通气的应用越