摘要
目的研究无创呼吸机对慢性阻塞性肺疾病(COPD)合并慢性呼吸衰竭患者肺功能及炎症因子的影响,为患者的治疗提供指导。方法选择2014年6月至2017年6月蒲城县医院收治的100例COPD合并慢性呼吸衰竭患者作为研究对象,采用随机数表法将患者分为对照组和观察组,每组50例。两组患者均给予抗感染、平喘、化痰、补液和对症治疗等常规治疗,对照组在常规治疗基础上,联合应用有创有创机械通气治疗,观察组患者在常规治疗基础上加用无创呼吸机治疗。治疗4周后,比较两组患者的临床疗效,比较分析两组治疗前后的肺功能指标[第1秒用力呼气容积(FEV1)、第1秒用力呼气量占用力肺活量的比值(FEV1/FVC)、最大呼气流量(PEF)]、炎症因子[白细胞介素-6 (IL-6)、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)]及血气指标[血氧分压(PaO2)、二氧化碳分压(PaCO2)、氢离子浓度指数(pH)]。结果治疗后,观察组患者的治疗总有效率为94.0%,明显高于对照组的74.0%,差异有统计学意义(P<0.05);治疗前,两组患者的肺功能、炎症因子和血气指标水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的FEV1、FEV1/FVC、PEF水平与治疗前比较明显升高,且观察组明显高于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者的IL-6、TNF-α、hs-CRP水平与治疗前比较明显降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者的PaO2、pH值与治疗前比较均明显升高,PaCO2明显降低,且观察组患者的PaO2、pH值明显高于对照组,PaCO2明显低于对照组,差异均有统计学意义(P<0.05)。结论 COPD合并慢性呼吸衰竭患者采用无创呼吸机治疗可有效改善患者肺功能及炎症因子水平,临床治疗效果显著,值得推广应用。
Objective To study the effect of noninvasive ventilator on pulmonary function and inflammatory factors in patients with chronic obstructive pulmonary disease(COPD)and chronic respiratory failure,and to provide guidance for the treatment of patients.Methods A total of 100 COPD patients with chronic respiratory failure,who admitted to Pucheng County Hospital from June 2014 to June 2017,were selected and divided into two groups,with 50 patients in each group.Both groups were given routine treatment such as anti-infection,anti-asthmatic,expectorant,fluid infusion and symptomatic treatment.The control group was treated with invasive mechanical ventilation on the basis of routine treatment,while the observation group was treated with noninvasive ventilator on the basis of routine treatment.After 4 weeks of treatment,the clinical effects of the two groups were compared,and the pulmonary function indexes including forced expiratory volume in the first second(FEV1),forced expiratory volume in the ratio of forced expiratory volume in the first second(FEV1/FVC),maximum expiratory flow(PEF),levels of inflammatory factors including interleukin-6(IL-6),tumor necrosis factorα(TNF-α),high sensitivity C-reactive protein(hs-CRP),blood gas index including blood oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2),hydrogen ion concentration index(pH)of the two groups before and after treatment were compared and analyzed.Results After treatment,the total effective rate of the observation group was 94.0%,which was significantly higher than 74.0%of the control group(P<0.05);before treatment,there was no significant difference in lung function,inflammatory factors and blood gas index between the two groups(all P>0.05);after treatment,FEV1,FEV1/FVC,PEF levels of the two groups were significantly higher than those before treatment,and the difference between the two groups was statistically significant(all P<0.05);after treatment,the levels of IL-6,TNF-αand hs-CRP in the two groups were significantly lower than those bef
作者
杨晓纲
郭辉
赵健
YANG Xiao-gang;GUO Hui;ZHAO Jian(Department of Respiratory Medicine,Department of Neurosurgery,Pucheng 715500,Shaanxi,CHINA;epartment of Respiratory Medicine Pucheng County Hospital,Pucheng 715500,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第12期1517-1520,共4页
Hainan Medical Journal
关键词
慢性阻塞性肺疾病
慢性呼吸衰竭
无创呼吸机
肺功能
炎症因子
Chronic obstructive pulmonary disease(COPD)
Chronic respiratory failure
Non-invasive ventilator
Lung function
Inflammatory factors
