摘要
目的:观察小剂量甲泼尼龙滴入联合无创呼吸机在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭治疗中的临床效果。方法:选取2021年7月—2022年7月德化县医院收治的60例COPD合并Ⅱ型呼吸衰竭患者为研究对象,按照随机盲法对照将患者分为联合组和常规组,各30例。常规组采用尼可刹米联合无创呼吸机治疗,联合组采用小剂量甲泼尼龙滴入联合无创呼吸机治疗。比较两组治疗前后血pH值、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、第1秒用力呼气容积(FEV_(1))、急性生理学及慢性健康状况评分系统(APACHEⅡ)评分及C反应蛋白(CRP)、血清降钙素原(PCT)、白细胞介素-17(IL-17),并比较两组呼吸衰竭纠正时间和临床疗效。结果:两组治疗前血pH值、PaCO_(2)、PaO_(2)比较,差异无统计学意义(P>0.05);联合组治疗后血pH值、PaO_(2)高于常规组,PaCO_(2)低于常规组,差异有统计学意义(P<0.05)。两组治疗前FEV_(1)、APACHEⅡ评分比较,差异无统计学意义(P>0.05);联合组治疗后FEV_(1)高于常规组,APACHEⅡ评分低于常规组,呼吸衰竭纠正时间短于常规组,差异有统计学意义(P<0.05)。两组治疗前血清CRP、PCT、IL-17水平比较,差异无统计学意义(P>0.05);联合组治疗后血清CRP、PCT、IL-17水平均低于常规组,差异有统计学意义(P<0.05)。联合组治疗后总有效率为93.33%,高于常规组的70.00%,差异有统计学意义(P<0.05)。结论:小剂量甲泼尼龙滴入联合无创呼吸机治疗COPD合并Ⅱ型呼吸衰竭,可改善患者血气状态,增强肺通气功能,缓解气道炎症反应,并提高疗效。
Objective:To observe the clinical effect of low-dose Methylprednisolone infusion combined with noninvasive ventilator in the treatment of chronic obstructive pulmonary disease(COPD)combined with typeⅡrespiratory failure.Method:A total of 60 patients with COPD combined with typeⅡrespiratory failure who treated in Dehua County Hospital from July 2021 to July 2022 were selected as the study objects,they were divided into the combination group and the routine group according to random blind control,30 cases in each group.The routine group was given Nikethamide combined with noninvasive ventilator,while the combination group was given low-dose Methylprednisolone infusion combined with noninvasive ventilator.The blood pH value,partial pressure of arterial carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),forced expiratory volume in one second(FEV_(1)),acute physiology and chronic health evaluation scoring system(APACHEⅡ)scores,C-reactive protein(CRP),serum procalcitonin(PCT)and interleukin-17(IL-17)in two groups were compared before and after treatment,the correction time of respiratory failure and clinical curative effect were compared.Result:There were no significant differences in blood pH value,PaCO_(2),PaO_(2) between two groups before treatment(P>0.05);the blood pH value and PaO_(2) in the combination group after treatment were higher than those in the routine group,while PaCO_(2) was lower than that in the routine group,the differences were statistically significant(P<0.05).There were no significant differences in FEV_(1) and APACHEⅡscore between two groups before treatment(P>0.05);the FEV_(1) in the combination group after treatment was higher than that in the routine group,the APACHEⅡscore was lower than that in the routine group,the correct time of respiratory failure was shorter than that in the routine group,the differences were statistically significant(P<0.05).There were no significant differences in the levels of CRP,PCT and IL-17 between two groups before treatment(P>0.05);the level
作者
连捷
许巧玲
陈素琼
李新锋
LIAN Jie;XU Qiaoling;CHEN Suqiong;LI Xinfeng(Dehua County Hospital,Dehua 362500,China;不详)
出处
《中外医学研究》
2023年第15期24-27,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
甲泼尼龙
无创呼吸机
慢性阻塞性肺疾病
Ⅱ型呼吸衰竭
临床疗效
Methylprednisolone
Noninvasive ventilator
Chronic obstructive pulmonary disease Type
Ⅱrespiratory failure
Clinical effect
