Noninvasive Positive Pressure Ventilation On Plateau Combined Curative Effect Observation Of Patients With Chronic Respiratory Failure Of COPD

BackgroundChronic obstructive pulmonary disease (COPD) is a chronic disease, the highincidence, mortality, fourth in the global disease cause of death. Investigation intoseven areas,20245adults in our country, among people who’s over40years old, copdprevalence rate is as high as8.2%, the hospitalized patients with AECOPD averagehospitalization cost as high as11598yuan each time. We always to the plateau in thetreatment of COPD, rely on long-term oxygen therapy, inhaled corticosteroids,bronchodilator, etc. These treatment, to some extent the hypoxemia in patients,airway obstruction, benefit part of patients obviously. But that kind of stability ofpatients with chronic respiratory failure, because more respiratory muscle fatigue,night respiratory center reaction is low, easy to merge carbon dioxide retention,traditional treatment cannot effectively alleviate the patient’s condition, and may bedue to the unreasonable oxygen cure aggravate the patient’s carbon dioxide retention,thus aggravating illness. Since the1990s, noninvasive ventilation technology hasmade great progress, now its curative effect in terms of respiratory failure, especiallyacute type ii respiratory failure caused by acute pulmonary edema and AECOPDaspect curative effect, become the first-line treatment. Always home noninvasive ventilation research on stability of patients with COPD is more, but with mixedresults. So we try to the stability of COPD patients with chronic chronic failure tolong-range respiratory support treatment, in order to observe whether it can improvethe patient’s life, tolerance, pulmonary function, arterial blood gas and reduce thehospitalization rate of patients.ObjectiveTo study the home noninvasive positive pressure ventilation technology for thetreatment of plateau combination of respiratory failure in patients with COPD, ashome noninvasive ventilation technology provides the theory basis for furtherpopularization.MethodsA retrospective analysis in January2009to June2013, caused by COPDcombined with acute respiratory failure in henan province, respiratory medicine chesthospital be in hospital, noninvasive positive pressure ventilation therapy or invasiveventilation of patients with COPD, entered stability after healing, still with chronicrespiratory failure and PaCO2≧55MMHG or low flow oxygen PaCO2≧50MMHG, a total of49cases, according to patients outside the court whether purchasebreathing machine for long-term home noninvasive ventilation were divided intotreatment group and control group, choose long-term home noninvasive mechanicalventilation patients as treatment group, a total of23cases. Choose long-term homeoxygen therapy as the control group, a total of26patients. Noninvasive ventilationgroup of men (19cases),4cases were female, routine treatment group (male17,female9cases. All stability combined with chronic respiratory failure of COPD in.the guide of diagnosis and treatment of chronic obstructive pulmonary disease.Exclusion criteria:(1) patients with bronchiectasis, bronchial asthma, pulmonarytuberculosis, interstitial lung disease and other respiratory diseases (2) with severepulmonary bullae (3) with severe arrhythmia, cardiac insufficiency in patients withsevere disease, and other system.Comparison of two groups of patients beforetreatment and after1years of treatment of arterial blood gas (Pa02, PaCO2),6minwalking test (6MWT), frequency and pulmonary function in1years (FEV1, FVC)were analyzed. Results1.the two groups of patients were compared to the baseline, there was nosignificant difference, comparable (P>0.05);2.noninvasive ventilation in the treatment group patients1years after PaCO2decreased、 PaO2increased significantly (P<0.05); conventional treatment groupimproved significantly (P>0.05).3.noninvasive ventilation in the treatment group patients1years after6MWTincreased、the admission number decreased significantly (P<0.05); conventionaltreatment group improved significantly (P>0.05).4.noninvasive ventilation in the treatment group patients1years after pulmonaryfunction in FEV1、 FVC does not improve significantly (P>0.05); conventionaltreatment group improved significantly (P>0.05).ConclusionThe home noninvasive ventilation is safe and effective,the application of COPDin stable stage of noninvasive positive pressure ventilation can improve arterial bloodgas、6MWT、times of hospitalization was reduced, but the uncertainty in improvingthe curative effect of pulmonary function.