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目的探讨无创机械通气疗法对慢性阻塞性肺疾病(COPD)并发Ⅱ型呼吸衰竭的老年患者的疗效。方法选取在我院治疗的老年COPD合并Ⅱ型呼吸衰竭患者40例随机平均分为两组,对照组采用常规治疗,如抗感染、平喘祛痰、支气管舒张剂、氧疗等;在对照组的基础上,观察组患者加用无创机械通气治疗。对两组患者治疗前后的呼吸频率、心率、血气分析结果如PaCO2、PaO2、pH以及两组患者的住院时间和有创呼吸机或气管插管的使用率进行比较。结果使用无创机械通气治疗后,观察组的呼吸频率降至(20.6±5.7)次/min、心率降至(75.9±8.3)次/min、PaO2上升至(84.5±6.4)mmHg、PaCO2下降至(48.4±5.2)mmHg,pH值上升至(7.41±0.03),与治疗前相比均得到很好改善,并且住院天数和气管插管率明显减少,和对照组相比差异显著,结果有统计学意义(P<0.05)。结论无创机械通气疗法治疗COPD并发Ⅱ型呼吸功能衰竭的老年患者疗效显著,可以减少患者的住院天数,降低气管插管的使用,值得临床上推广。
Objective To investigate the effect of non-invasive mechanical ventilation on elderly patients with chronic obstructive pulmonary disease (COPD) complicated by respiratory failure. Methods Forty elderly patients with COPD and type Ⅱ respiratory failure who were treated in our hospital were randomly divided into two groups. The control group received routine treatment such as anti-infective, asthma and expectorant, bronchodilator and oxygen therapy. In the control group Based on the observation group patients with non-invasive mechanical ventilation therapy. Respiratory rate, heart rate, blood gas analysis results such as PaCO2, PaO2, pH, hospital stay and invasive ventilator or endotracheal intubation rates were compared between the two groups before and after treatment. Results After noninvasive mechanical ventilation, the respiratory rate of the observation group decreased to (20.6 ± 5.7) / min, the heart rate decreased to (75.9 ± 8.3) / min, the PaO2 increased to (84.5 ± 6.4) mmHg and the PaCO2 decreased to ( 48.4 ± 5.2) mmHg, and the pH value increased to (7.41 ± 0.03), both of which were significantly improved compared with those before treatment. The days of hospitalization and tracheal intubation were significantly decreased, with significant difference compared with the control group Significance (P <0.05). Conclusion Noninvasive mechanical ventilation therapy for elderly patients with COPD complicated by respiratory failure of type Ⅱ has significant curative effect, which can reduce the hospitalization days and reduce the use of endotracheal intubation, which is worth to be popularized clinically.