Efficacy of bronchoalveolar lavage combined with noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease complicated with type II respiratory failure
10.3760/cma.j.issn.1008-6706.2016.17.021
- VernacularTitle:支气管肺泡灌洗联合无创正压通气治疗慢性阻塞性肺疾病并Ⅱ型呼吸衰竭的疗效观察
- Author:
Yongjin ZHANG
- Publication Type:Journal Article
- Keywords:
Pulmonary disease,chronic obstructive;
Respiratory insufficiency;
Bronchoalveolar lavage;
Continuous positive airway pressure
- From:
Chinese Journal of Primary Medicine and Pharmacy
2016;23(17):2641-2644,2645
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe and investigate the effect of bronchoalveolar lavage (BAL)joint non -invasive positive pressure ventilation (NIPPV)in treatment of chronic obstructive pulmonary disease(COPD)with type II respiratory failure.Methods 110 patients of COPD combined with type Ⅱrespiratory failure were selected. According to the random number table method,all the patients were divided into observation group and control group. Except routine therapy,the observation group was treated with BAL combined with NIPPV treatment,the control group was treated with NIPPV treatment alone.The heart rate,APACHE Ⅱscore changes,blood gas index,mean arterial pressure and adverse reactions occurrences were compared between the two groups.Results Four hours after treatment,the pH of the observation group was significantly increased to (7.36 ±0.06),and compared with the control group (7.32 ±0.05),the difference was statistically significant (t =3.798,P <0.05 ).Four hours after treatment,PaCO2 level of the observation group was significantly decreased to (59.4 ±12.9)mmHg,which was lower than (69.3 ±11.3)mmHg in the control group,the difference was statistically significant (t =-4.281,P <0.05). 24h after treatment,the PaO2 level of the observation group was significantly increased to (74.8 ±17.2)mmHg, which was significantly higher than (64.7 ±15.1)mmHg of the control group,and the difference was statistically significant (t =3.273,P <0.05 ).There were no statistically significant differences in mean arterial pressure and heart rate at each time point of the two groups (P >0.05).12h after treatment,APACHE II scores of the two groups were significantly decreased,in the observation group,the APACHE II score from (10.8 ±2.5)points decreased to (7.8 ±1.9)points,and in the control group,the APACHE II score from (11.8 ±4.3)points decreased to (9.9 ± 4.5)points,APACHE II score of the observation group decreased more obviously than the control group,and the difference was statistically significant (t =-3.188,P <0.05).The incidence rate of adverse reaction of the observation group (18.18%)was significantly lower than the control group (63.64%).Conclusion BAL combined with NIPPV in the treatment of COPD with type II respiratory failure can effectively improve symptoms in patients with breathing difficulties,improve PaO2 level,reduce PaCO2 level and APACHE II score,and reduce the incidence of adverse reactions,which has good clinical application value.
