Bi PAP呼吸机无创通气联合氧气驱动雾化吸入对慢阻肺合并呼吸衰竭的疗效

摘要 目的：研究Bi PAP呼吸机无创通气以及氧气驱动雾化吸入联用对慢性阻塞性肺疾病（慢阻肺）合并呼吸衰竭的疗效。方法：选择2016年12月～2018年12月我院的121例慢阻肺合并呼吸衰竭患者，随机分为两组。对照组采用Bi PAP呼吸机无创通气疗法，观察组联合氧气驱动雾化吸入布氨溴索和地奈德混悬液。比较两组的呼吸频率、血气指标和心率；血清肺表面活性相关蛋白D(Pulmonary surfactant related protein，SP-D)以及部活化调节趋化因子(PARC/CCL18)水平、肺功能。结果：观察组的有效率明显高于对照组(P<0.05)；治疗后，两组的呼吸频率、血气指标和心率明显改善(P<0.05)，且观察组的呼吸频率、血气指标和心率明显优于对照组(P<0.05)；治疗后，两组的血清PARC/CCL18 以及SP-D水平均明显降低(P<0.05)，且观察组的血清PARC/CCL18 以及SP-D水平明显低于对照组(P<0.05)；治疗后，两组的FEV₁%、呼吸困难指数以及FEV₁/FVC明显改善(P<0.05)，且观察组的FEV₁%、呼吸困难指数以及FEV₁/FVC明显优于对照组(P<0.05)。结论：Bi PAP呼吸机无创通气以及氧气驱动雾化吸入联用能改善慢阻肺合并呼吸衰竭的血气指标、生命体征和肺功能，降低血清 PARC/CCL18 以及SP-D水平。

Effect of Bi PAP Ventilator Noninvasive Ventilation Combined with Oxygen Driven Atomization Inhalation on COPD with Respiratory Failure

ABSTRACT Objective: To study the effect of Bi PAP ventilator noninvasive ventilation combined with oxygen driven atomization inhalation on COPD with respiratory failure. Methods: Selected 121 cases of COPD patients with respiratory failure who were treated in our hospital from 2018 2016 to December 2018, divided into two groups randomly. The control group used Bi PAP ventilator noninvasive ventilation therapy, the observation group combined with oxygen driven atomization inhalation of ambroxol and desnide suspension. The respiratory rate, blood gas index and heart rate, the level of SP-D, PARC / ccl18 and lung function were compared between the two groups. Results: The effective rate of the observation group was significantly higher than control group (P<0.05). After treatment, the respiratory rate, blood gas index and heart rate of the two groups were significantly improved (P<0.05), and the respiratory rate, blood gas index and heart rate of the observation group were significantly better than those of the control group (P<0.05). After treatment, the serum Parc / ccl18 and SP-D levels of the two groups were significantly lower(P<0.05), and the serum Parc / ccl18 and SP-D levels of the observation group were significantly lower than those of the control group(P<0.05). After treatment, FEV₁%, dyspnea index and FEV₁/FVC of the two groups were significantly improved (P<0.05), and FEV₁%, dyspnea index and FEV₁/FVC of the observation group were significantly better than those of the control group (P<0.05). Conclusion: The combination of Bi PAP ventilator noninvasive ventilation and oxygen driven atomization inhalation can improve the blood gas index, vital signs and lung function of COPD with respiratory failure, and reduce the serum Parc / ccl18 and SP-D levels.