吴晓文;余伟鹏;冼美兰;

• 1:汕头市潮阳区大峰医院呼吸内科

摘要(Abstract)：

目的研究无创正压通气联合布地奈德福莫特罗粉吸入剂治疗慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭的疗效。方法按标准纳入57例COPD合并Ⅱ型呼吸衰竭患者,按随机数字表法随机分成两组,对照组给予常规治疗及布地奈德福莫特罗粉吸入剂吸入,观察组在对照组的基础上给予无创正压通气治疗,动态观察两组患者通气、氧合、心率、呼吸频率等改善情况。结果观察组患者开始治疗2h后,呼吸困难相关临床症状明显好转,心率、呼吸频率显示下降,Pa CO2下降,Pa O2升高,比对照组显著改善,差异有统计学意义(P<0.05)。观察组在治疗72h后,预后改善情况均明显好于对照组,差异有统计学意义(P<0.05)。观察组病愈出院率较高,而插管率、病死率较低,住院时间较短,与对照组比较,差异有统计学意义(P<0.05)。结论布地奈德福莫特罗粉吸入剂联合无创正压通气治疗慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭,可有效缓解临床症状,改善患者预后,安全有效。

关键词(KeyWords)： 慢性阻塞性肺疾病;Ⅱ型呼吸衰竭;无创正压通气;布地奈德福莫特罗粉吸入剂

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 吴晓文;余伟鹏;冼美兰;

Email:

DOI: 10.13799/j.cnki.mdjyxyxb.2015.03.004

参考文献(References)：

• [1]Ford ES,Mannino DM,Giles WH,et al.Prescription Practices for Chronic Obstructive Pulmonary Disease:Findings from the National Ambulatory Medical Care Survey 1999-2010.COPD,2014,11(3):247-255.
• [2]Mapel DW,Roberts MH.Management of asthma and chronic obstructive pulmonary disease with combination inhaled corticosteroids and long-actingβ-agonists:a review of comparative effectiveness research.Drugs,2014,74(7):737-755.
• [3]Nannini LJ,Poole P,Milan SJ,et al.Combined corticosteroid and long-acting beta2-agonist in one inhaler versus placebo for chronic obstructive pulmonary disease.Cochrane Database Syst Rev,2013,36(11):1256-1269.
• [4]黄楚丽.无创正压通气治疗COPD急性加重合并重度Ⅱ型呼吸衰竭的疗效观察[J].中国现代医生,2014,17(26):133-135.
• [5]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
• [6]刘升明,王小平,王大礼,等.广东部分地区慢性阻塞性肺疾病发病状况调查[J].中华医学杂志,2005,85(8):747-752.
• [7]Karabis A,Mocarski M,Eijgelshoven I,et al.Economic evaluation of aclidinium bromide in the management of moderate to severe COPD:an analysis over 5 years.Clinicoecon Outcomes Res,2014,6:175-185.
• [8]Nannini LJ,Poole P,Milan SJ,et al.Combined corticosteroid and long-acting beta(2)-agonist in one inhaler versus inhaled corticosteroids alone for chronic obstructive pulmonary disease.Cochrane Database Syst Rev,2013,21(8):716-725.
• [9]Fukuchi Y,Samoro R,Fassakhov R,et al.Budesonide/formoterol via Turbuhaler versus formoterol via Turbuhaler in patients with moderate to severe chronic obstructive pulmonary disease:phase III multinational study results.Respirology,2013,18(5):866-873.
• [10]Gao SY,Huang JQ,Luo YF,et al.Comparison of the lung function change in patients with COPD and bronchial asthma before and after treatment with budesonide/formoterol.J Thorac Dis,2012,4(6):583-587.
• [11]Larsson K,Janson C,Lisspers K,et al.Combination of budesonide/formoterol more effective than fluticasone/salmeterol in preventing exacerbations in chronic obstructive pulmonary disease:the PATHOS study.J Intern Med,2013,273(6):584-594.
• [12]詹庆元,黄絮.无创正压通气治疗急性低氧性呼吸衰竭的指征[J].中华医学杂志,2014,94(38):2966-2967.
• [13]赵蕾,丁薇,曾海珠.无创正压通气治疗老年慢性阻塞性肺病并Ⅱ型呼吸衰竭患者的疗效观察[J].中国老年学杂志,2014,19(13):3740-3741.
• [14]李波,陈明贤.双水平无创正压通气治疗慢性阻塞性肺疾病急性加重期并发呼吸衰竭的疗效观察[J].中国基层医药,2014,21(3):358-360.
• [15]童国强,熊小明,罗于琳.无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭疗效观察[J].实用心脑肺血管病杂志,2014,22(3):69-70.