摘要
目的探讨无创正压通气(NIPPV)治疗慢性阻塞性肺疾病急性加重(AECOPD)患者合并意识障碍的临床效果。方法选取AECOPD合并意识障碍患者63例,随机分为观察组与对照组,2组均给予常规治疗,观察组在常规治疗的基础上立即应用NIPPV治疗,首次NIPPV治疗时间在2 h以上,至少持续治疗3 d;对照组只采用常规药物治疗。对比2组治疗前及治疗后2、24、72 h心率(HR)、呼吸频率(RR)、格拉斯哥昏迷评分(GCS)、血气指标变化情况,及治疗前后痰液与血液中IL-8水平。结果 2组患者治疗前各项指标比较无统计学意义(P>0.05);观察组治疗2 h后,HR、RR、GCS、PaCO2较治疗前显著下降,pH、PaO2较治疗前显著升高,治疗前后比较差异有统计学意义(P<0.05),治疗后24、72 h持续改善;对照组治疗2 h后各项指标与治疗前比较无统计学意义(P>0.05);治疗24 h后,各项指标较治疗前显著改善(P<0.05),但显著低于观察组。观察组治疗后痰液、血液中IL-8水平显著低于对照组,组间比较差异有统计学意义(P<0.05)。结论 NIPPV治疗AECOPD合并意识障碍,可迅速改善患者通气状态,治疗意识障碍。
Objective To study the curative effect of non-invasive positive pressure ventilation （NIPPV） on disturbance of consciousness in acute exacerbation of chronic obstructive pulmonary diseases （AECOPD）. Methods A total of 63 patients of AECOPD with disturbance of consciousness were randomly divided into observation group and control group. The patients of two groups were given conventional treatment. The observation group was given NIPPV treatment immediately on the basis of conventional treatment. The first time NIPPV treatment lasted more than 2 h, for at least 3 consecutive days. The control group was only given routine medical treatment. 2,24,72 h heart rate （HR）, respiratory rate （RR）, Glasgow Coma Scale （GCS） ,changes of blood gas index,the levels of sputum and IL-8 levels in the blood before and after treatment were compared. Results There was no statistical difference of the indicators between two groups of patients before treatment （ P 〉 0.05） ; HR, RR, GCS, PCO2 after treatment for 2 h showed a significant reduction in observation group, pH and PaO2 were significantly elevated after treatment, the comparative difference was statistically significant before and after treatment （ P 〈 0.05）, and showed a continuous improvement after treatment for 24 and 72 h. There was no obvious changes of each index after treatment for 2 h in control group （ P 〉 0.05） ; After 24 h treatment, the indicators were improved significantly （ P 〈 0.05）, but significanflylower than those of the observation group. After treatmem, sputum and IL-8 in the blood of observation group were significantly lower than those of control group, and the differences between groups were statistically significant （ P 〈 0.05）. Conclusion NIPPV for treating disturbance of consciousness in AECOPD can quickly improve ventilation condition of patients with definite effect.
出处
《长春中医药大学学报》
2014年第3期524-526,共3页
Journal of Changchun University of Chinese Medicine
基金
国家自然科学基金(31000091)
