CAJ | 학술논문

目的：研究应用无创机械通气治疗维吾尔族人群慢性阻塞性肺疾病(COPD)的效果。方法选择我院呼吸内科2013年1月~2015年6月住院的200例维吾尔族COPD急性加重(AECOPD)期呼吸衰竭患者,随机分为治疗组和对照组各100例,两组均给予抗感染,祛痰,平喘,应用糖皮质激素、支气管舒张剂雾化吸入或静脉给药,并给予对症支持治疗,治疗组同时应用多功能高端无创呼吸机,经口鼻面罩给予无创正压通气治疗；对照组同时给予鼻导管或口鼻面罩持续低流量吸氧治疗。观察并对比两组患者的临床治疗效果及血气分析pH、PaO2、PaCO2的改善情况,转ICU率及平均住院天数。结果经治疗,治疗组患者的总有效率为93%,对照组为71%,治疗组显著优于对照组,差异有统计学意义(P<0.05)；治疗组患者的血气分析pH、PaO2、PaCO2较对照组改善显著,差异有统计学意义(P<0.05)；治疗组患者转ICU率为3%,对照组为12%,治疗组转ICU率明显少于对照组,差异有统计学意义(P<0.05)；治疗组患者平均住院天数为(11.3±2.7)d,对照组为(16.4±3.6)d,治疗组患者平均住院天数明显少于对照组,差异有统计学意义(P<0.05)。结论对AECOPD期呼吸衰竭的患者应用无创正压通气治疗,效果显著,不仅能提高临床疗效,还可提高患者的PaO2、降低PaCO2,改善患者的血液pH值,减少转ICU率及住院天数,值得推广应用。
목적：연구응용무창궤계통기치료유오이족인군만성조새성폐질병(COPD)적효과。방법선택아원호흡내과2013년1월~2015년6월주원적200례유오이족COPD급성가중(AECOPD)기호흡쇠갈환자,수궤분위치료조화대조조각100례,량조균급여항감염,거담,평천,응용당피질격소、지기관서장제무화흡입혹정맥급약,병급여대증지지치료,치료조동시응용다공능고단무창호흡궤,경구비면조급여무창정압통기치료；대조조동시급여비도관혹구비면조지속저류량흡양치료。관찰병대비량조환자적림상치료효과급혈기분석pH、PaO2、PaCO2적개선정황,전ICU솔급평균주원천수。결과경치료,치료조환자적총유효솔위93%,대조조위71%,치료조현저우우대조조,차이유통계학의의(P<0.05)；치료조환자적혈기분석pH、PaO2、PaCO2교대조조개선현저,차이유통계학의의(P<0.05)；치료조환자전ICU솔위3%,대조조위12%,치료조전ICU솔명현소우대조조,차이유통계학의의(P<0.05)；치료조환자평균주원천수위(11.3±2.7)d,대조조위(16.4±3.6)d,치료조환자평균주원천수명현소우대조조,차이유통계학의의(P<0.05)。결론대AECOPD기호흡쇠갈적환자응용무창정압통기치료,효과현저,불부능제고림상료효,환가제고환자적PaO2、강저PaCO2,개선환자적혈액pH치,감소전ICU솔급주원천수,치득추엄응용。
Objective To study the clinical therapy method and effect of chronic obstructive pulmonary disease in Uighur people. Methods 200 Uighur acute exacerbations of chronic obstructive pulmonary disease and with respiratory failure patients from January 2013 to June 2015 of our hospital respiratory medicine were selected.Patients were randomly di-vided into control group and treatment group,and each group had 100 patients.Both two groups were given anti-infec-tion,removing phlegm,glucocorticoid,bronchial relaxation atomizing inhalation or intravenous administration and symp-tomatic relief and supportive treatment.Patients in treatment group were given multifunctional high-end noninvasive ventilator through the nose and mouth mask for noninvasive positive pressure ventilation therapy at the same time.Pa-tients in control group were given nasal catheter or nose and mouth mask continuous low flow oxygen therapy.Clinical therapy effect,improvement situation of blood gas analysis pH,PaO2 and PaCO2,the rate of turn to ICU and average hos-pitalization days were observed in two groups after treatment. Results After treatment,the total effective rate was 93%in treatment group,which was significantly higher than that was 71% in control group and the difference was statistical significance (P<0.05).The blood gas analysis pH,PaO2 and PaCO2 in treatment group improved more than control group, and the difference was statistical significance (P<0.05).The rate of turn to ICU in treatment group and control group were respectively 3% and 12%;the average hospitalization days in treatment group and control group were respectively (11.3±2.7) d and (16.4±3.6) d.The rate of turn to ICU and average hospitalization days in treatment group were obvious less to control group,and the differences were statistical significance (P<0.05). Conclusion The clinical therapy effect is ob-vious by using noninvasive positive pressure ventilation therapy for acute exacerbations of chronic obstructive pul-monary disease and with respiratory failure patients.It can improve clinical effect,enhance the PaO2,decrease PaCO2,im-prove the blood pH of patients,reduce the rate of turn to ICU,reduce the hospitalization days.It is worth to popu-larize in clinical.