CAJ | 학술논문

目的：探讨支气管肺泡灌洗（BAL）联合无创正压通气（NIPPV）治疗慢性阻塞性肺疾病（COPD）合并II型呼吸衰竭的临床效果。方法：选取我中心2011年1月至2013年1月间出诊送到同一家医院且收治的COPD合并II型呼吸衰竭的患者86例，随机分为观察组与对照组，观察组在常规治疗的基础上应用BAL联合NIPPV 治疗，对照组单独采用NIPPV 治疗，对比两组患者血气指标、心率、平均动脉压、APACHE II评分变化及不良反应发生情况。结果：两组患者治疗后PaCO2均较治疗前显著下降，治疗前后比较差异有统计学意义（P＜0．05）；观察组患者治疗后PaCO2下降较对照组更加迅速，组间比较差异有统计学意义（ P＜0．05）；且观察组患者在治疗后24h、48h PaO2均显著高于对照组，组间比较差异有统计学意义（ P＜0．05）；且观察组患者气管插管率显著低于对照组，组间比较差异有统计学意义（ P＜0．05）；两组患者心率、平均动脉压治疗24h后比较无统计学差异（ P＞0．05）。结论：BAL联合NIPPV治疗COPD合并Ⅱ型呼吸衰竭能有效的降低患者PaCO2，提高PaO2，可迅速缓解患者呼吸衰竭症状，是治疗COPD合并II型呼吸衰竭的有效治疗方案。
목적：탐토지기관폐포관세（BAL）연합무창정압통기（NIPPV）치료만성조새성폐질병（COPD）합병II형호흡쇠갈적림상효과。방법：선취아중심2011년1월지2013년1월간출진송도동일가의원차수치적COPD합병II형호흡쇠갈적환자86례，수궤분위관찰조여대조조，관찰조재상규치료적기출상응용BAL연합NIPPV 치료，대조조단독채용NIPPV 치료，대비량조환자혈기지표、심솔、평균동맥압、APACHE II평분변화급불량반응발생정황。결과：량조환자치료후PaCO2균교치료전현저하강，치료전후비교차이유통계학의의（P＜0．05）；관찰조환자치료후PaCO2하강교대조조경가신속，조간비교차이유통계학의의（ P＜0．05）；차관찰조환자재치료후24h、48h PaO2균현저고우대조조，조간비교차이유통계학의의（ P＜0．05）；차관찰조환자기관삽관솔현저저우대조조，조간비교차이유통계학의의（ P＜0．05）；량조환자심솔、평균동맥압치료24h후비교무통계학차이（ P＞0．05）。결론：BAL연합NIPPV치료COPD합병Ⅱ형호흡쇠갈능유효적강저환자PaCO2，제고PaO2，가신속완해환자호흡쇠갈증상，시치료COPD합병II형호흡쇠갈적유효치료방안。
Objective:To investigate the effect of bronchoalveolar lavage ( BAL ) joint non-invasive positive pressure ventilation (NIPPV) in treatment of chronic obstructive pulmonary disease (COPD) com-bined with typeⅡrespiratory failure. Method:A total of 106 patients with COPD combined with type Ⅱre-spiratory failure admitted in our hospital from Jan. 2011 to Jan. 2013 were randomly divided into observation group and control group. Observation group was treated with BAL on the basis of NIPPV treatment, control group adopted NIPPV treatment alone, compared two groups of patients with blood gas index, heart rate, breathing rate, APACHE II score changes and adverse reactions occurrence. Result:After treatment, PaCO2 in two groups was decreased with statistically significant difference (P<0. 05); PaCO2 in observation group declined more rapidly than the control group (P<0. 05), and PaO2 in observation group after the treatment of 24 hours and 48 h were significantly higher than that of control group ( P<0. 05), tracheal intubation rate in observation group was significantly lower than that of control group ( P<0. 05);There were no statistical differences of heart rate, mean arterial pressure, score after treatment of 24 hours between the two groups of patients ( P>0. 05). Conclusion:Therapy of the BAL joint NIPPV in treating COPD combined with type Ⅱrespiratory failure can more effectively reduce PaCO 2, improve PaO2, can rapidly alleviate symptoms of pa-tients with respiratory failure, so this is an effective therapy in the treatment of COPD with type II respiratory failure. Objective:To investigate the effect of bronchoalveolar lavage ( BAL ) joint non-invasive positive pressure ventilation (NIPPV) in treatment of chronic obstructive pulmonary disease (COPD) com-bined with typeⅡrespiratory failure. Method:A total of 106 patients with COPD combined with type Ⅱre-spiratory failure admitted in our hospital from Jan. 2011 to Jan. 2013 were randomly divided into observation group and control group. Observation group was treated with BAL on the basis of NIPPV treatment, control group adopted NIPPV treatment alone, compared two groups of patients with blood gas index, heart rate, breathing rate, APACHE II score changes and adverse reactions occurrence. Result:After treatment, PaCO2 in two groups was decreased with statistically significant difference (P<0. 05); PaCO2 in observation group declined more rapidly than the control group (P<0. 05), and PaO2 in observation group after the treatment of 24 hours and 48 h were significantly higher than that of control group ( P<0. 05), tracheal intubation rate in observation group was significantly lower than that of control group ( P<0. 05);There were no statistical differences of heart rate, mean arterial pressure, score after treatment of 24 hours between the two groups of patients ( P>0. 05). Conclusion:Therapy of the BAL joint NIPPV in treating COPD combined with type Ⅱrespiratory failure can more effectively reduce PaCO 2, improve PaO2, can rapidly alleviate symptoms of pa-tients with respiratory failure, so this is an effective therapy in the treatment of COPD with type II respiratory failure.