Randomized controlled trial of noninvasive positive pressure ventilation technology combined with respiratory stimulant in the treatment of pulmonary encephalopathy in patients with COPD
10.3760/cma.j.issn.1008-6706.2015.16.008
- VernacularTitle:无创正压通气联合呼吸兴奋剂治疗慢性阻塞性肺疾病并发肺性脑病的随机对照研究
- Author:
Chunping HUANG
;
Rongchang ZHI
;
Jinlun HUANG
;
Zhitao LIU
;
Rui XIAO
;
Yinhuan LI
- Publication Type:Journal Article
- Keywords:
Artifcial ventilation;
Respiratory stimulant;
Pulmonary encephalopathy;
Pulmonary disease,chro-nic obstructive
- From:
Chinese Journal of Primary Medicine and Pharmacy
2015;(16):2423-2426,2427
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of noninvasive positive pressure ventilation technology com-bined with respiratory stimulant in the treatment of pulmonary encephalopathy in patients with COPD.Methods For-ty -eight COPD patients with early pulmonary encephalopathy were included.They were randomly divided into the treatment group and control group.The treatment group was treated by not only regular treatment and noninvasive posi-tive pressure ventilation technology,but also respiratory stimulant.The control group was only treated by regular treat-ment and noninvasive positive pressure ventilation technology.The indexes were recorded,including tracheal intubation rate,clinical recovery rate,mortality,Glasgow coma score,arterial blood gas analysis and adverse reactions.Results Compared with the control group,the arterial blood gas analysis of treatment group on the 2h,24h and 72h were statis-tically significant different(P <0.05).The GCS score on the 24h and 72h were also statistically significant different [24h,(13.4 ±1.6)vs.(11.8 ±2.1),P <0.05;72h,(14.6 ±1.5)vs.(12.4 ±2.4),P <0.05].The treatment group had lower tracheal intubation rate(12% vs.56.5%,P =0.001),shorter consciousness recovery time[(3.0 ± 0.5)h vs.(5.6 ±0.7)h,P =0.023],shorter hospitalization time in ICU[(12.6 ±1.5)d vs.(19.2 ±1.8)d,P =0.004]and better clinical recovery(22 /25 vs.10 /23,P =0.001)than the control group.But the mortality rate had no significant difference between the two groups(1 /25 vs.4 /23,P =0.129).Conclusion NIPPV combined with respiratory stimulant is an effective,safe and simple method for treatment of COPD complicated with pulmonary encephalopathy.It can significantly improve the clinical symptoms and the index of arterial blood gas analysis,and it can shorten consciousness recovery time and decrease tracheal intubation rate.But close observation must be carried out,and the invasive mechanical ventilation should be promptly executed in case of emergency or exacerbation.
