刘桂周

【摘要】 目的：探討无创呼吸机联合雾化吸入治疗对慢性阻塞性肺疾病急性加重期（AECOPD）合并呼吸衰竭的临床疗效。方法：选取2017年2月-2019年2月本院收治的50例AECOPD合并呼吸衰竭患者。按照随机数字表法将其分为对照组和观察组，各25例。对照组采用无创呼吸机进行无创正压通气治疗，观察组在对照组基础上实施雾化吸入治疗，比较两组临床疗效、症状缓解时间、肺通气功能指标（FEV1、FEV1/FVC）、动脉血气分析指标（PaO2、PaCO2）、中转有创机械通气比例。结果：观察组总有效率为96.00%，高于对照组的76.00%（P<0.05）;观察组咳嗽、咳痰、呼吸困难等症状缓解时间均短于对照组（P<0.05）;治疗后，观察组FEV1、FEV1/FVC、PaO2均高于对照组，PaCO2低于对照组，比较差异均有统计学意义（P<0.05）;观察组中转有创机械通气比例低于对照组（P<0.05）。结论：无创呼吸机联合雾化吸入治疗可有效缓解AECOPD合并呼吸衰竭患者的临床症状，改善其肺通气功能、动脉血气状况，有利于提高患者的临床疗效，避免患者因治疗无效而中转有创机械通气治疗。

【关键词】 慢性阻塞性肺疾病; 呼吸衰竭; 无创呼吸机; 雾化吸入

【Abstract】 Objective：To investigate the clinical effect of non-invasive ventilator and atomization on acute exacerbation of chronic obstructive pulmonary disease（AECOPD）with respiratory failure.Method：A total of

50 AECOPD patients with respiratory failure from February 2017 to February 2019 in our hospital were selected.According to the random number table method，they were divided into control group and observation group，25 cases in each group.The control group was treated with non-invasive positive pressure ventilation by non-invasive ventilator，while observation group was treated with atomization inhalation on the basis of control group.The clinical efficacy，symptoms relief time，lung ventilation function index（FEV1，FEV1/FVC），arterial blood gas analysis index（PaO2，PaCO2）and the proportion of transitional invasive mechanical ventilation between two groups were compared.

Result：The total effective rate of observation group was 96.00%，which was higher than 76.00% of control group（P<0.05）.The relief time of cough，sputum and dyspnea in observation group were shorter than those of control group（P<0.05）.After treatment，the levels of FEV1，FEV1/FVC and PaO2 in observation group were higher than those of control group，and PaCO2 was lower than that of control group，the differences were statistically significant（P<0.05）.The conversion rate of invasive mechanical ventilation in observation group was lower than that of control group（P<0.05）.

Conclusion：Non-invasive ventilator combined with atomization inhalation therapy can effectively relieve the clinical symptoms of patients with AECOPD combined with respiratory failure，improve their pulmonary ventilation function and arterial blood gas status，and is conducive to improving the clinical efficacy of patients，so as to prevent patients from transferring to invasive mechanical ventilation treatment due to ineffective treatment.

【Key words】 Chronic obstructive pulmonary disease; Respiratory failure; Non-invasive ventilator; Atomization inhalation

First-authors address：Chaozhou Chaoan District Peoples Hospital，Chaozhou 515600，China

doi：10.3969/j.issn.1674-4985.2019.08.011

慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）属于临床常见多发疾病，由于患者肺通气功能受到影响，其并发呼吸衰竭的风险较高，而一旦合并发生呼吸衰竭，患者的生命安全将会受到严重威胁，临床上需对该疾病实施积极治疗[1-3]。本研究选取本院呼吸内科就诊的50例AECOPD合并呼吸衰竭患者（2017年2月-2019年2月）进行前瞻性研究，以探讨无创呼吸机联合雾化吸入治疗对AECOPD合并呼吸衰竭的临床疗效。现报道如下。

1 资料与方法

1.1 一般资料 选取2017年2月-2019年2月本院收治的50例AECOPD合并呼吸衰竭患者。纳入标准：经临床症状观察、实验室检查，证实为AECOPD并发呼吸衰竭;对研究知情同意。排除标准：无法耐受机械通气治疗者;无法耐受药物治疗者;近30 d内具有糖皮质激素用药史者。按照随机数字表法将其分为对照组和观察组，各25例。本研究经医院伦理学委员会批准。

1.2 方法 （1）对照组……