支气管镜联合无创正压通气治疗慢性阻塞性肺疾病并呼吸衰竭的疗效

发布时间：2019-02-27 08:08

【摘要】：目的探讨慢性阻塞性肺疾病(COPD)合并呼吸衰竭采用纤维支气管镜联合无创正压通气(NIPPV)治疗的临床疗效。方法按照随机数字表法将2012年3月至2015年3月该院收治的63例COPD合并呼吸衰竭患者分为两组,对照组(31例)行内科综合治疗联合NIPPV治疗,观察组(32例)在对照组基础上联合经鼻插入纤维支气管镜治疗,比较两组治疗后临床疗效及有创机械通气发生率、病死率、住院时间,观察治疗前后动脉血气分析指标。结果观察组治疗后临床有效率87.50%,高于对照组的64.52%(P0.05)。两组患者治疗后pH值、PaO_2、SaO_2均较治疗前升高,PaCO_2较治疗前下降(均P0.05),观察组治疗后pH值、PaO_2、PaCO_2、SaO_2均较对照组改善明显(均P0.05)。观察组有创机械通气发生率、病死率均低于对照组,住院时间少于对照组(均P0.05)。结论纤维支气管镜联合NIPPV治疗COPD合并呼吸衰竭患者具有临床疗效好、血气状况改善明显、安全可靠的特点,临床有重要参考价值。
[Abstract]:Objective to evaluate the efficacy of fiberoptic bronchoscopy combined with non-invasive positive pressure ventilation (NIPPV) in the treatment of chronic obstructive pulmonary disease (COPD) with respiratory failure. Methods from March 2012 to March 2015, 63 patients with COPD complicated with respiratory failure were divided into two groups: control group (31 cases) received combined treatment of internal medicine and NIPPV. The observation group (n = 32) was treated with fiberoptic bronchoscopy combined with nasal insertion on the basis of the control group. The clinical curative effect, the incidence of invasive mechanical ventilation, the mortality, the length of hospitalization and the indexes of arterial blood gas analysis before and after treatment were compared between the two groups. Results the clinical effective rate of the observation group was 87.50%, which was higher than that of the control group (64.52%, P0.05). After treatment, the pH value, PaO_2,SaO_2 and PaCO_2 of the two groups were higher than that of the control group (P 0.05), and the pH value and PaO_2,PaCO_2,SaO_2 of the observation group after treatment were significantly improved than those of the control group (all P0.05). The incidence of invasive mechanical ventilation in the observation group was lower than that in the control group, and the hospitalization time was less than that in the control group (P0.05). Conclusion Fiberoptic bronchoscopy combined with NIPPV has a good clinical effect, improved blood gas status, and is safe and reliable in the treatment of COPD with respiratory failure. It has important clinical reference value.
【作者单位】：武汉市第三医院呼吸内科;
【分类号】：R563.9

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