摘要
目的探讨双水平正压通气(BiPAP)联合雾化吸入沙丁胺醇、异丙托溴铵和氨溴索治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者的临床疗效。方法将80例COPD合并Ⅱ型呼吸衰竭患者随机分为治疗组和对照组,每组40例。2组均采用常规治疗联合BiPAP通气,治疗组在此基础上给予雾化吸入沙丁胺醇、异丙托溴铵和氨溴索。观察2组治疗前和治疗7 d后动脉血气(PaO2、PaCO2)、肺通气功能(FEV1、FEV1/FVC)、呼吸频率(RR)、呼吸困难程度评分(MMRC)、气管插管率、死亡率和平均住院时间等指标。结果治疗7 d后,2组PaO2、PaCO2、FEV1、FEV1/FVC、RR、MMRC、气管插管率和住院时间均较同组治疗前明显改善(P<0.05),且治疗组改善情况优于对照组(P<0.05);治疗组病死率低于对照组,但差异无统计学意义(P>0.05)。结论 BiPAP联合雾化吸入沙丁胺醇、异丙托溴铵和氨溴索治疗COPD合并Ⅱ型呼吸衰竭能明显改善患者的呼吸衰竭、肺功能和呼吸困难症状,降低气管插管率,缩短住院时间。
Objective To explore the efficacy of bi - level positive airway pressure （Bi- PAP） combined with aerosol inhalation of salbutamol, ipratropium bromide and ambroxol on the treatment of chronic obstructive pulmonary disease （COPD） patients with type 1I respiratory fail- ure. Methods 80 COPD patients with type II respiratory failure were randomly divided into treatment group and control group, 40 cases in each group. Both groups were treated with conven- tional therapy and BiPAP, and the treatment group was treated with additional aerosol inhalation of salbutamol, ipratropium bromide and ambroxol. Changes of indexes such as arterial blood gas （PaO2, PaCO2）, pulmonary ventilation function （FEV1, FEV1/FVC）, respiratory rate （RR）, modified medical research council （MMRC） dyspnea scale, intubation rate, mortality rate and mean hospital stay were observed and compared in stages of before treatment and 7 days after treat- ment between two groups. Results 7 days after treatment, the indexes such as PaO2, PaCO2, FEV1, FEV1/F＇VC, RR, MMRC, intubation rate and mean hospital stay were significantly im- proved （P 〈 0.05）, and the improvements in the treatment group were significantly better than those in the control group（P 〈 0.05）. Though the mortality rate in the treatment group was lower than that in the control group, there was no significant difference （P 〉0.05）. Conclusion Ap- plication of BiPAP combined with aerosol inhalation of salbutamol, ipratropium bromide and am- broxol in treatment of COPD patients with type 1] respiratory failure can effectively alleviate the symptoms of respiratory failure, pulmonary function and dyspnea, reduce the intubation rate and shorten the hospital stay.
出处
《实用临床医药杂志》
CAS
2013年第23期23-25,34,共4页
Journal of Clinical Medicine in Practice
关键词
慢性阻塞性肺疾病
Ⅱ型呼吸衰竭
双水平正压通气
雾化吸入
chronic obstructive pulmonary disease
type II respiratory failure
bi - level positive airway pressure
aerosol inhalation
