无创正压通气治疗慢性阻塞性肺疾病合并急性呼吸衰竭患者临床疗效及患者睡眠质量监测

王峰 江照明

摘要 目的：探讨NIPPV治疗COPD合并急性呼吸衰竭的临床疗效。方法：选取2017年4月至2019年12月安徽省立医院感染病院收治的COPD合并急性呼吸衰竭患者80例作为研究对象，按照双盲信封法分为对照组和观察组，每组40例。对照组给予常规治疗，观察组给予NIPPV治疗。调查统计2组患者动脉血气指标、呼吸频率、心率以及后期气管插管率以及睡眠质量情况。结果：观察组患者酸碱度、PaO2、PaCO2均优于对照组（P<0.05）;观察组呼吸频率、心率指标均优于对照组（P<0.05）;观察组后期接受有创机械通气例数明显低于对照组（P<0.05）;治疗前2组患者PQSI评分比较，差异无统计学意义（P>0.05）;治疗后观察组PQSI评分明显低于对照组，差异有统计学意义（P<0.05）。结论：采用NIPPV的方式进行治疗，有利于缓解呼吸肌疲劳、改善患者的病理生理状况、降低气管插管率，改善患者睡眠质量，具有一定的治疗价值。

关键词 NIPPV;COPD;急性呼吸衰竭;临床研究

Clinical Effect of Noninvasive Positive Pressure Ventilation on Patients with Chronic Obstructive Pulmonary Disease Complicated with Acute Respiratory Failure and Monitoring of Sleep Quality

WANG Feng，JIANG Zhaoming

（Anhui Provincial Hospital Infection Hospital/Hefei Infectious Hospital，Hefei 230000，China）

Abstract Objective：To explore the clinical efficacy of NIPPV in the treatment of COPD with acute respiratory failure.Methods：Randomly selected 80 cases of COPD with acute respiratory failure admitted to our hospital from April 2017 to December 2019 as the research object，and divided them into a control group and a observation group of 40 cases according to the double-blind envelope method.Treatment，the observation group was given NIPPV treatment.Investigation and statistics of arterial blood gas indexes，respiratory rate，heart rate，and later tracheal intubation rate and sleep quality of the two groups of patients.Results：The pH，PaO2，PaCO2 of the observation group were better than the control group（P<0.05）; The respiration frequency and heart rate index of the observation group were better than the control group（P<0.05）; Lower than the control group（P<0.05）; Before treatment，the PQSI score of the two groups of patients was not statistically significant（P>0.05）; After treatment，the PQSI score of the observation group was significantly lower than the control group，the difference was statistically significant P<0.05）.Conclusion：Treatment with NIPPV is beneficial to relieve respiratory muscle fatigue，improve the pathophysiological condition of patients，reduce the rate of tracheal intubation，and improve the quality of sleep of patients.

Keywords NIPPV; COPD; Acute respiratory failure; Clinical research

中图分类号：R338.63  文献标识码：A  doi：10.3969/j.issn.2095-7130.2020.09.070

近年来，随着环境污染日益严重，慢性阻塞性肺疾病（COPD）的患病持续增加，多发于老年人群，致残率、致死率均高，诸多患者均合并呼吸衰竭。针对COPD的患者治疗过程中，常规采取机械通气治疗，但其创伤性较大、不良反应较多，对患者的预后产生不良影响[1]。NIPPV不仅可以缓解患者的缺氧症状，减少并发症，而且无需建立人工气道，避免造成创伤。我院选取80例慢性阻塞性肺疾病合并急性呼吸衰竭的患者，对其采用不同的治疗方案，探讨无创正压通气治療慢性阻塞性肺疾病合并急性呼吸衰竭的临床疗效，现报道如下。