无创通气序贯治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的效果

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Abstract Objective To explore the clinical value of noninvasive ventilation sequential (NIPPV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with respiratory failure. Methods One hundred and twenty patients with AECOPD complicated with respiratory failure treated in the First People's Hospital of Huzhou City from July 2015 to July 2017 were selected and they were divided into two groups by random number table, with 60 cases in each group. The control group received conventional invasive positive pressure ventilation (IPPV) and the observation group received NIPPV support. Clinical indicators, vital signs, N-terminal pro-brain natriuretic peptide (NT-proBNP), pulmonary infection and health status were compared between the two groups. Results The durations of intensive care, total duration of mechanical ventilation and invasive ventilation in the observation group were all shorter than those in control group, with statistically significant differences (P ＜ 0.05). In observation group, the re-intubation rate was 3.33% (2/60) and the incidence of ventilator-associated pneumonia (VAP) was 3.33% (2/60), while in the control group, the re-intubation rate was 15.00% (9/60) and the incidence of VAP was 16.67% (10/60), the differences between the two groups were statistically significant (P ＜ 0.05). The levels of heart rate (HR), respiratory rate (RR) and partial pressure of carbon dioxide (PaCO2) in the observation group were lower than those in the control group, and the levels of pH and partial pressure of blood oxygen (PaO2) were higher than those in the control group (P ＜ 0.05). Before treatment, the levels of NT-proBNP, clinical pulmonary infection score (CPIS) and acute physiology and chronic health evaluation (APACHE-Ⅱ) scores of lung infection in the two groups showed no significant differences (P ＞ 0.05). After treatment, the levels of NT-proBNP, CPIS and APACHE-Ⅱ scores in the observation group were lower than those in the control group, with significant differences (P ＜ 0.05). Conclusion For patients with AECOPD complicated with respiratory failure, NIPPV can help to shorten the ventilation duration, improve their vital signs, reduce the risk of lung infection, maintain good health status and enhance the clinical efficacy.

Key words： Infection Respiratory failure Noninvasive ventilation sequential therapy Invasive positive pressure ventilation technique Vital signs

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	ZHONG Chunmiao JI Zhaohui ZHOU Pingping HU Xianquan FU Kai

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ZHONG Chunmiao JI Zhaohui ZHOU Pingping HU Xianquan FU Kai. Effect of sequential non-invasive ventilation for acute exacerbation of chronic obstructive pulmonary disease complicated with respiratory failure[J]. 中国医药导报, 2018, 15(14): 89-92,106.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I14/89

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