无创呼吸机在慢性阻塞性肺疾病急性加重期应用的疗效评价
发布时间：2018-09-02 07:51
【摘要】：目的：探讨无创呼吸机在已经出现呼吸肌疲劳但不伴有呼吸衰竭的慢性阻塞性肺疾病急性加重期(AECOPD)患者中的应用价值。方法：70例呼吸肌疲劳的AECOPD患者随机分为对照组和无创呼吸机正压通气(NIPPV)治疗组,对照组给予常规治疗；NIPPV治疗组在常规治疗的基础上给予无创呼吸机正压通气(NIPPV),评价两组患者治疗前和治疗一周后临床症状、体征、血气分析和肺功能情况。结果：两组患者治疗后临床症状及体征评分均较治疗前改善(P0.05),NIPPV治疗组改善更为明显(P0.05)；NIPPV治疗组症状改善时间较对照组更短(P0.05)；治疗后两组的pH、PaO2、SaO2和PaCO2较治疗前改善(P0.05),和对照组相比,治疗后NIPPV治疗组的PaO2和PaCO2改善更明显(P0.05),而pH和SaO2无显著差异(P0.05)；治疗后两组的FEV1, FVC, FEV1实测值/预计值和FEV1/FVC均较治疗前升高(P0.05),NIPPV治疗组的FEV1实测值/预计值和FEV1/FVC升高更明显(P0.05)。结论：对呼吸肌疲劳的AECOPD患者,即使不伴有呼吸衰竭,早期应用NIPPV治疗能有效改善临床症状和体征,缩短症状改善时间,改善通气,缓解呼吸肌疲劳,预防呼吸衰竭的发生。
[Abstract]:Objective: to investigate the value of noninvasive ventilator in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory muscle fatigue but no respiratory failure. Methods 70 AECOPD patients with respiratory muscle fatigue were randomly divided into two groups: the control group and the non-invasive ventilator positive pressure ventilation (NIPPV) group. The control group was treated with routine therapy. NIPPV group was treated with non-invasive positive ventilator ventilation (NIPPV),) on the basis of routine therapy to evaluate the clinical symptoms, signs, blood gas analysis and pulmonary function before treatment and one week after treatment. Results: the scores of clinical symptoms and signs were improved after treatment in both groups (P0.05). The improvement time of NIPPV in NIPPV group was significantly shorter than that in control group (P0.05). The pH,PaO2,SaO2 and PaCO2 of the two groups were improved after treatment (P0.05), compared with the control group, the improvement of PaO2 and PaCO2 in the NIPPV group was more obvious (P0.05), but there was no significant difference between pH and SaO2 (P0.05). After treatment, the FEV1, FVC, FEV1 measured / predicted value and FEV1/FVC were significantly higher than those before treatment (P0.05). The FEV1 / predicted value and FEV1/FVC in NIPPV treatment group were significantly higher than those before treatment (P0.05). Conclusion: for patients with respiratory muscle fatigue, even without respiratory failure, early application of NIPPV can effectively improve clinical symptoms and signs, shorten symptom improvement time, improve ventilation, relieve respiratory muscle fatigue and prevent respiratory failure.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R563.9
本文编号：2218731
[Abstract]:Objective: to investigate the value of noninvasive ventilator in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory muscle fatigue but no respiratory failure. Methods 70 AECOPD patients with respiratory muscle fatigue were randomly divided into two groups: the control group and the non-invasive ventilator positive pressure ventilation (NIPPV) group. The control group was treated with routine therapy. NIPPV group was treated with non-invasive positive ventilator ventilation (NIPPV),) on the basis of routine therapy to evaluate the clinical symptoms, signs, blood gas analysis and pulmonary function before treatment and one week after treatment. Results: the scores of clinical symptoms and signs were improved after treatment in both groups (P0.05). The improvement time of NIPPV in NIPPV group was significantly shorter than that in control group (P0.05). The pH,PaO2,SaO2 and PaCO2 of the two groups were improved after treatment (P0.05), compared with the control group, the improvement of PaO2 and PaCO2 in the NIPPV group was more obvious (P0.05), but there was no significant difference between pH and SaO2 (P0.05). After treatment, the FEV1, FVC, FEV1 measured / predicted value and FEV1/FVC were significantly higher than those before treatment (P0.05). The FEV1 / predicted value and FEV1/FVC in NIPPV treatment group were significantly higher than those before treatment (P0.05). Conclusion: for patients with respiratory muscle fatigue, even without respiratory failure, early application of NIPPV can effectively improve clinical symptoms and signs, shorten symptom improvement time, improve ventilation, relieve respiratory muscle fatigue and prevent respiratory failure.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R563.9
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