摘要
目的探讨不同通气方式治疗急诊科慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭的疗效。方法方便选择该院急诊科2018年1月-2019年12月收治的COPD并Ⅱ型呼吸衰竭患者60例为对象,随机数表法将患者分成对照组(n=30)和观察组(n=30)。对照组用气管插管通气,观察组用无创呼吸机通气。检测并比较两组患者治疗前后24 h的肺功能及血气指标变化,观察和比较两组患者治疗前后1周的心率及呼吸频率、肺部体征和发热、咳嗽、喘憋与呼吸困难等症状与体征的变化。结果治疗24 h时,观察组的FEV1%perd(53.6±18.5)%高于对照组(34.9±17.3)%,差异有统计学意义(t=4.044,P=0.043);观察组的FEV1/FVC(56.8±10.4)%高于对照组(43.7±10.5)%,差异有统计学意义(t=4.855,P=0.040);观察组的PaO2(89.1±10.3)mmHg高于对照组(72.5±10.6)mmHg, PaCO2(53.7±9.4)mmHg低于对照组(69.5±10.6)mm Hg,差异有统计学意义(t=6.152、6.108,P=0.034、0.037);观察组的临床治疗总有效率93.3%高于对照组73.3%,差异有统计学意义(χ2=4.320,P=0.038)。结论急诊科采用无创呼吸机通气治疗COPD并Ⅱ型呼吸衰竭的效果显著,能在治疗24 h明显改善患者的临床症状与体征,恢复并稳定患者的肺功能,血气指标充分改善,治疗总有效率高,临床应用价值高于气管插管有创通气。
Objective To investigate the efficacy of different ventilation methods in the treatment of chronic obstructive pulmonary disease(COPD) and type Ⅱ respiratory failure in the emergency department. Methods Sixty patients with COPD and type Ⅱ respiratory failure admitted to the emergency department of the hospital from January 2018 to December 2019 were selected as subjects. The patients were divided into a control group(n=30) and an observation group(n= 30). The control group was ventilated with tracheal intubation, and the observation group was ventilated with a non-invasive ventilator. The pulmonary function and blood gas index changes at 24 h before and after treatment were detected and compared between the two groups. The heart rate, respiratory rate, and lungs changes in symptoms and signs such as fever,cough, wheezing, and difficulty breathing of the two groups were observed and compared for 1 week before and after treatment. Results At 24 h of treatment, the FEV1%perd(53.6±18.5)% of the observation group was higher than that of the control group(34.9±17.3)%,and the difference was statistically significant(t=4.044, P=0.043);the FEV1/FVC(56.8±10.4)%of the observation group was higher In the control group(43.7±10.5)%,and the difference was statistically significant(t=4.855,P=0.040);PaO2(89.1±10.3) mmHg of the observation group was higher than that of the control group(72.5±10.6) mmHg,PaCO2(53.7±9.4) mmHg was lower than the control group(69.5±10.6) mmHg,and the difference was statistically significant(t=6.152,6.108, P=0.034, 0.037);the total effective rate of clinical treatment in the observation group was 93.3% higher than that in the control group, 73.3%,and the difference was statistically significant(χ2=4.320, P=0.038). Conclusion The use of non-invasive ventilator ventilation in the emergency department to treat COPD and type Ⅱ respiratory failure is effective. It can significantly improve the patient’s clinical symptoms and signs within 24 h of treatment, restore and stabilize the patient�
作者
李萍
徐刚
LI Ping;XU Gang(Observation Room,Qingpu Branch,Zhongshan Hospital,Fudan University,Shanghai,201799 China;Emergency Department,Qingpu Branch,Shanghai Fudan University Hospital,Shanghai,201799 China)
出处
《中外医疗》
2021年第6期35-37,共3页
China & Foreign Medical Treatment
关键词
慢性阻塞性肺疾病
呼吸衰竭
急诊科
气管插管通气
无创呼吸机通气
Chronic obstructive pulmonary disease
Respiratory failure
Emergency department
Tracheal intubation ventilation
Non-invasive ventilator ventilation
