无创呼吸机联合乙酰半胱氨酸治疗伴Ⅱ型呼吸衰竭COPD患者的价值分析

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摘要 目的：探讨对伴有Ⅱ型呼吸衰竭慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）患者予无创呼吸机通气联合乙酰半胱氨酸（N-acetyl cysteine,NAC）溶液雾化吸入治疗的临床价值。方法：将我院2020年5月―2022年1月收治的169例COPD合并Ⅱ型呼吸衰竭（respiratory failure,RF）患者以随机数字表法分为对照组84例和观察组85例,对照组予常规治疗联合无创通气治疗,观察组在对照组基础上予NAC溶液雾化吸入治疗,为期7 d。观察两组临床疗效、治疗前后血气指标、呼吸力学变化及肺功能情况。结果：与对照组88.10%的总有效率相比,观察组97.65%的总有效率更高。治疗7 d后,与对照组氧分压（PaO₂）、pH值及氧饱和度（SpO₂）相比,观察组更高;与对照组二氧化碳分压（PaCO₂）相比,观察组更低。与对照组潮气量（VT）、吸气时间分数（Ti/Ttot）相比,观察组更高;与对照组呼吸频率（RR）相比,观察组更低;与对照组1 s用力呼气量（FEV1）、用力肺活量（FVC）及最大通气量（MVV）相比,观察组更高。结论：无创呼吸机通气联合NAC溶液雾化吸入能够提高临床疗效,有效改善COPD合并Ⅱ型RF患者血气指标、呼吸力学指标及肺功能。

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	马春梅
	段玲
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关键词 ：无创呼吸机, 乙酰半胱氨酸, 雾化吸入, Ⅱ型呼吸衰竭, 慢性阻塞性肺疾病

Abstract：Objective To explore the clinical value of non-invasive ventilator ventilation combined with acetylcysteine (NAC) solution aerosol inhalation on patients with type II respiratory failure (RF) complicated with chronic obstructive pulmonary disease (COPD). Methods 169 patients with COPD complicated with type II RF who were treated in the hospital from May 2020 to January 2022 were divided into the control group (84 cases) and the observation group (85 cases) according to the random number table method. The control group was given conventional treatment combined with non-invasive ventilation, while the observation group was treated with NAC solution for aerosol inhalation on the basis of the control group, and both groups were treated for 7 days. The clinical efficacy, as well as blood gas indicators, respiratory mechanics changes and pulmonary function before and after treatment were observed in the two groups. Results The total effective rate was 97.65% in the observation group, which was higher than 88.10% in the control group. After 7 days of treatment, the partial pressure of oxygen (PaO₂), PH value and oxygen saturation (SpO₂₎in the observation group were higher while the partial pressure of carbon dioxide (PaCO₂) was lower compared to the control group. The tidal volume (VT) and fractional inspiratory time (Ti/Ttot) were higher while the respiratory rate (RR) was lower in the observation group compared to the control group. The forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and maximum ventilation volume (MVV) in the observation group were higher than those in the control group. Conclusion Non-invasive ventilator ventilation combined with aerosol inhalation of NAC solution can enhance the clinical efficacy, and effectively improve the blood gas indicators, respiratory mechanics indicators and pulmonary function in patients with COPD and type II RF.

Key words： non-invasive ventilator acetylcysteine aerosol inhalation type II respiratory failure chronic obstructive pulmonary disease

收稿日期: 2023-04-14

中图分类号:

R563.8

基金资助:四川省科技厅科研课题（2023NSFSC0742）

通讯作者: 李红永,E-mail：286859186@qq.com

引用本文:

马春梅, 段玲, 杜晶, 李红永. 无创呼吸机联合乙酰半胱氨酸治疗伴Ⅱ型呼吸衰竭COPD患者的价值分析[J]. 湖南师范大学学报(医学版), 2023, 20(3): 84-87. MA Chunmei, DUAN Ling, DU Jing, LI Hongyong. Value of non-invasive ventilator combined with acetylcysteine in the treatment of patients with type II respiratory failure and COPD. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(3): 84-87.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2023/V20/I3/84

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