【摘要】：目的：探討無創(chuàng)呼吸機(jī)在已經(jīng)出現(xiàn)呼吸肌疲勞但不伴有呼吸衰竭的慢性阻塞性肺疾病急性加重期(AECOPD)患者中的應(yīng)用價(jià)值。方法：70例呼吸肌疲勞的AECOPD患者隨機(jī)分為對(duì)照組和無創(chuàng)呼吸機(jī)正壓通氣(NIPPV)治療組,對(duì)照組給予常規(guī)治療；NIPPV治療組在常規(guī)治療的基礎(chǔ)上給予無創(chuàng)呼吸機(jī)正壓通氣(NIPPV),評(píng)價(jià)兩組患者治療前和治療一周后臨床癥狀、體征、血?dú)夥治龊头喂δ芮闆r。結(jié)果：兩組患者治療后臨床癥狀及體征評(píng)分均較治療前改善(P0.05),NIPPV治療組改善更為明顯(P0.05)；NIPPV治療組癥狀改善時(shí)間較對(duì)照組更短(P0.05)；治療后兩組的pH、PaO2、SaO2和PaCO2較治療前改善(P0.05),和對(duì)照組相比,治療后NIPPV治療組的PaO2和PaCO2改善更明顯(P0.05),而pH和SaO2無顯著差異(P0.05)；治療后兩組的FEV1, FVC, FEV1實(shí)測(cè)值/預(yù)計(jì)值和FEV1/FVC均較治療前升高(P0.05),NIPPV治療組的FEV1實(shí)測(cè)值/預(yù)計(jì)值和FEV1/FVC升高更明顯(P0.05)。結(jié)論：對(duì)呼吸肌疲勞的AECOPD患者,即使不伴有呼吸衰竭,早期應(yīng)用NIPPV治療能有效改善臨床癥狀和體征,縮短癥狀改善時(shí)間,改善通氣,緩解呼吸肌疲勞,預(yù)防呼吸衰竭的發(fā)生。
[Abstract]:Objective: to investigate the value of noninvasive ventilator in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory muscle fatigue but no respiratory failure. Methods 70 AECOPD patients with respiratory muscle fatigue were randomly divided into two groups: the control group and the non-invasive ventilator positive pressure ventilation (NIPPV) group. The control group was treated with routine therapy. NIPPV group was treated with non-invasive positive ventilator ventilation (NIPPV),) on the basis of routine therapy to evaluate the clinical symptoms, signs, blood gas analysis and pulmonary function before treatment and one week after treatment. Results: the scores of clinical symptoms and signs were improved after treatment in both groups (P0.05). The improvement time of NIPPV in NIPPV group was significantly shorter than that in control group (P0.05). The pH,PaO2,SaO2 and PaCO2 of the two groups were improved after treatment (P0.05), compared with the control group, the improvement of PaO2 and PaCO2 in the NIPPV group was more obvious (P0.05), but there was no significant difference between pH and SaO2 (P0.05). After treatment, the FEV1, FVC, FEV1 measured / predicted value and FEV1/FVC were significantly higher than those before treatment (P0.05). The FEV1 / predicted value and FEV1/FVC in NIPPV treatment group were significantly higher than those before treatment (P0.05). Conclusion: for patients with respiratory muscle fatigue, even without respiratory failure, early application of NIPPV can effectively improve clinical symptoms and signs, shorten symptom improvement time, improve ventilation, relieve respiratory muscle fatigue and prevent respiratory failure.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R563.9

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