摘要
目的探讨无创双水平正压通气联合糖皮质激素治疗慢性阻塞性肺疾病(COPD)急性加重期患者的效果。方法采用前瞻性随机试验方法,选择2018年1月至2020年3月天津市滨海新区大港医院收治的156例COPD急性加重期患者,采用抽签法分为对照组和试验组,各78例。对照组在常规治疗基础上采用丙酸氟替卡松进行治疗,试验组在对照组基础上进行无创双水平正压通气治疗,两组连续治疗7 d,比较两组治疗前、治疗7 d后的血气指标及炎症指标水平。结果治疗前,两组动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))比较,差异无统计学意义(P>0.05);治疗7 d后,两组PaO_(2)均高于治疗前,且试验组高于对照组,两组PaCO_(2)均低于治疗前,且试验组低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗7 d后,两组hs-CRP、TNF-α水平均低于治疗前,且试验组低于对照组,差异有统计学意义(P<0.05)。结论无创双水平正压通气联合糖皮质激素治疗COPD急性加重期患者,可使患者血气指标得到改善,机体炎症反应有所减轻。
Objective To investigate the effect of non-invasive bi-level positive pressure ventilation combined with glucocorticoid in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A prospective randomized trial was conducted to select 156 patients with acute exacerbation of COPD who were admitted to Dagang Hospital of Binhai New District,Tianjin from January 2018 to March 2020.They were divided into control group and experimental group by lot,with 78 patients in each group.The control group was treated with fluticasone propionate on the basis of conventional treatment,and the experimental group was treated with non-invasive dual-level positive pressure ventilation on the basis of the control group.The two groups were treated continuously for 7 days.The blood gas indexes and inflammation indexes of the two groups were compared before and after treatment for 7 days.Results Before treatment,there were no significant differences between the two groups in the partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))(P>0.05).After 7 d of treatment,PaO_(2) in both groups was higher than before treatment,and the experimental group was higher than the control group;PaCO_(2) in both groups was lower than before treatment,and the experimental group was lower than the control group,with statistical significance(P<0.05).Before treatment,there were no significant differences in the levels of hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)between the two groups(P>0.05).After 7 days of treatment,the levels of hs-CRP and TNF-αin both groups were lower than before treatment,and the test group was lower than the control group,with statistical significance(P<0.05).Conclusion Noninvasive bi-level positive pressure ventilation combined with glucocorticoid can improve the blood gas index and alleviate the inflammatory response in patients with acute exacerbation of COPD.
作者
孙树志
Sun Shuzhi(Tianjin Binhai New District Dagang Hospital,Tianjin 300270,China)
出处
《医疗装备》
2021年第10期1-2,5,共3页
Medical Equipment
关键词
慢性阻塞性肺疾病
急性加重期
无创双水平正压通气
糖皮质激素
炎症反应
Chronic obstructive pulmonary disease
Acute exacerbation
Non-invasive dual-level positive pressure ventilation
Glucocorticoid
Inflammatory response
