无创呼吸机联合复方异丙托溴铵雾化吸入在慢阻肺急性加重期中的应用

王琴 黄小红 朱齐琦

[摘要] 目的 無创呼吸机联合复方异丙托溴铵雾化吸入在慢阻肺急性加重期中的应用效果。 方法 2013年3月～2017年3月60例慢性阻塞性肺急性加重期患者被纳入本次研究。实施随机均等分组研究，对照组实施常规治疗，如止咳化痰、抗感染等，观察组在其基础上联合实施无创呼吸机与复方异丙托溴铵雾化吸入治疗。对两组患者的住院时间、APACHEⅡ评分、两组的气管插管情况等进行比较分析。 结果 治疗后两组患者气管插管情况统计结果显示，对照组和观察组分别为8例和3例，气管插管率存在统计学差异（P<0.05）。另外，两组患者的氧分压以及二氧化碳分压、APACHEⅡ评分等治疗前无显著差异，治疗后差异显著，住院时间也具有统计学意义（P<0.05）。 结论 在对慢性阻塞性肺疾病急性加重期患者进行治疗的过程中，需要在常规治疗的基础上进行无创呼吸机联合复方异丙托溴铵雾化治疗，有效减短患者的住院时间，改善患者的氧分压等，总体治疗效果显著，具备推广使用价值。

[关键词] 慢性阻塞性肺疾病；急性加重期；无创呼吸机；复方异丙托溴铵；雾化吸入治疗

[中图分类号] R563.9；R563.8 [文献标识码] B [文章编号] 1673-9701（2018）15-0091-03

Application of non-invasive ventilator combined with compound ipratropium bromide inhalation in acute exacerbation of chronic obstructive pulmonary disease

WANG Qin HUANG Xiaohong ZHU Qiqi

Department of Geriatrics， the First People's Hospital of Jiujiang City in Jiangxi Province， Jiujiang 332000， China

[Abstract] Objective To evaluate the effect of non-invasive ventilator combined with compound ipratropium bromide inhalation in the acute exacerbation of chronic obstructive pulmonary disease. Methods 60 patients with acute exacerbation of chronic obstructive pulmonary disease were included in this study. Data were collected from March 2013 to March 2017. Participants were randomly and equally divided into observational group and control group. The control group was given routine treatment such as relieving cough and reducing sputum， anti-infection， etc. On the basis of control group， the observation group was given combined with non-invasive ventilator combined with compound ipratropium bromide inhalation therapy. The hospitalization time， APACHE Ⅱ score， tracheal intubation status of the two groups were compared and analyzed. Results The results showed that after different treatments there were 8 cases of tracheal intubation in the control group and 3 cases in the observation group， and the tracheal intubation rate was statistically different（P<0.05）. In addition， there was no significant difference in partial pressure of oxygen， partial pressure of carbon dioxide and APACHE Ⅱ score between the two groups before treatment， while the difference was significant after treatment， and the length of hospitalization was also statistically significant（P<0.05）. Conclusion In the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease， a non-invasive ventilator combined with compound ipratropium bromide on the basis of routine treatment can effectively shorten the hospital stay， improve the patient's oxygen partial pressure， and the overall treatment effect is significant， which deserve promotion.

[Key words] Chronic obstructive pulmonary disease； Acute exacerbation； Non-invasive ventilator； Compound ipratropium bromide； Aerosol inhalation therapy

根据我国所发布的关于慢性阻塞性肺疾病相关的调查数据显示，在我国慢阻肺疾病中，40岁以上的成年人占8.2%，而重度患者人数达1300万，以此为基础进行推算，我国每年因为慢阻肺疾病死亡的人数已经超过100万人[1-3]。在我国众多类型的疾病中，慢阻肺疾病也成为仅次于脑中风、恶性肿瘤以及心脏类相关疾病之后的第四位死亡率较高的疾病[4]。慢阻肺急性加重期患者由于起病急、疾病發展速度快，因此更需要尽早接受治疗。慢阻肺患者一般会出现肺功能不同程度下降，容易使患者发生呼吸衰竭，严重威胁生命安全[5]。临床治疗过程中需要结合患者的实际病情进行对症治疗。由于医疗技术的进步，无创呼吸机得到了广泛的应用，在具体治疗过程中患者需要接触到面罩，避免有创呼吸机带来的更大伤害和副作用，不仅缩短治疗时间，而且显著提高治疗效率。……