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目的对比分析慢性阻塞性肺疾病急性发作患者早期应用无创呼吸机鼻罩和面罩呼吸的临床效果。方法选择河北枣强县人民医院呼吸内科2012年1月至2014年7月收治的100例慢性阻塞性肺疾病急性发作早期患者,将其随机分成鼻罩组和面罩组各50例,全部患者在抗感染、平喘、解挛、激素和排痰治疗的基础上,分别给予鼻罩呼吸和面罩呼吸,对两组患者24 h后的疗效进行对比分析。结果在全部100例中,有14例改用气管插管机械通气,其中鼻罩组患者中3例,面罩组患者中11例,鼻罩组患者的插管率显著低于面罩组患者,两者比较差异有统计学意义(P<0.05);84例临床体征和症状得到有效改善,改用鼻导管给氧;2例临床症状和体征稍微缓解,继续观察。鼻罩组患者动脉CO2分压平均下降水平显著优于面罩组患者,两者比较差异有统计学意义(P<0.05)。两组患者在动脉分压平均上升水平和不良反应发生率方面,比较差异无统计学意义(P>0.05)。结论临床治疗慢性阻塞性肺疾病急性发作早期患者时,和面罩呼吸相比,无创呼吸机鼻罩呼吸的疗效更好,患者治疗费用能得到有效降低,可以将其作为慢性阻塞性肺疾病急性发作早期的一种常规治疗方式。
Objective To compare and analyze the clinical effect of early non-invasive ventilator nasal mask and mask respiration in patients with acute exacerbation of chronic obstructive pulmonary disease. Methods A total of 100 patients with acute exacerbation of chronic obstructive pulmonary disease who were admitted to Department of Respiratory Medicine, Zaoqiang People’s Hospital of Hebei Province from January 2012 to July 2014 were randomly divided into nasal mask group and mask group (n = 50) Anti-infection, anti-asthma, anti-seizures, hormones and expectoration on the basis of treatment, were given nasal mask respiration and mask respiration, the two groups of patients after 24 h of comparative analysis. Results Of the 100 cases, 14 were switched to mechanical ventilation with endotracheal intubation. Among them, 3 patients in nasal mask group, 11 patients in mask group and intubation rate in nasal mask group were significantly lower than those in mask group. Two (P <0.05). The clinical signs and symptoms of 84 patients were effectively improved. The nasal catheter was used instead of oxygen. The clinical symptoms and signs of 2 patients were slightly relieved, and the observation was continued. The mean decrease of arterial CO2 partial pressure in nasal mask group was significantly better than that in mask group, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the average arterial partial pressure rise and the incidence of adverse reactions (P> 0.05). Conclusion In the early stage of acute exacerbation of chronic obstructive pulmonary disease, non-invasive respirator nasal mask breathing is more effective than mask respiration, the treatment cost can be effectively reduced, which can be used as an acute exacerbation of chronic obstructive pulmonary disease An early routine treatment.