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目的对临床上慢性阻塞性肺疾病合并呼吸衰竭患者应用无创正压通气治疗的效果进行观察,为慢性阻塞性肺疾病合并呼吸衰竭疾病的临床治疗提供理论依据。方法选择2014年2月至2015年4月慢性阻塞性肺疾病合并呼吸衰竭患者40例,随机分成观察组与对照组。对照组进行气管插管有创通气,观察组进行无创正压通气。观察患者通气前后30 min以及通气后48 h血气指标的改善情况,记录两组患者的住院时间。结果通气30 min后观察组动脉血氧分压明显高于对照组,动脉血二氧化碳分压明显低于对照组,差异均有统计学意义(P<0.05)。观察组通气48 h后动脉血氧分压和动脉血二氧化碳分压与对照组通气48 h后相比差异未见统计学意义(P>0.05)。观察组住院时间显著短于对照组,差异有统计学意义(P<0.05)。结论慢性阻塞性肺疾病合并呼吸衰竭应用无创正压通气具有无创性且不良反应较少,故在临床应用上更加安全、灵活,更加容易让患者与家属所接受,而且降低了插管率,降低呼吸机相关性肺炎的发生率,有利于改善患者呼吸状况及其康复。
Objective To observe the clinical effect of non-invasive positive pressure ventilation on patients with chronic obstructive pulmonary disease and respiratory failure, and to provide a theoretical basis for the clinical treatment of chronic obstructive pulmonary disease with respiratory failure. Methods From February 2014 to April 2015, 40 patients with chronic obstructive pulmonary disease and respiratory failure were randomly divided into observation group and control group. The control group was intubated invasive ventilation, observation group for noninvasive positive pressure ventilation. The improvement of blood gas index was observed 30 min before and after ventilation and 48 h after ventilation, and the hospitalization time was recorded in both groups. Results After 30 minutes of ventilation, the partial pressure of arterial oxygen in the observation group was significantly higher than that in the control group. The arterial partial pressure of carbon dioxide was significantly lower than that of the control group (P <0.05). After 48 hours of ventilation in the observation group, there was no significant difference between the partial pressure of arterial oxygenation and the partial pressure of arterial carbon dioxide after 48 hours of ventilation in the control group (P> 0.05). The hospitalization time of the observation group was significantly shorter than that of the control group, the difference was statistically significant (P <0.05). Conclusion The application of non-invasive positive pressure ventilation in chronic obstructive pulmonary disease combined with respiratory failure is noninvasive and has few adverse reactions. Therefore, it is safer and more flexible in clinical application, and is more easily accepted by patients and their families. Moreover, it reduces the intubation rate and decreases The incidence of ventilator-associated pneumonia is conducive to improving the patient’s respiratory status and rehabilitation.