Clinic Study Of Noninvasive Positive Pressure Ventilation In Treatment Of Elder Patients In Lu Zhi District Due To Acute Exacerbation Of Chronic Obstructive Pulmonary Disease With Type Ⅱ Respiratory Failure

Objective: To explore the application of noninvasive positive pressureventilation (NIPPV) therapy in elderly AECOPD with type II respiratoryfailure treated in Luzhi district. To summarize the relevant experience andprovide evidence for clinical treatment of elderly patients with AECOPD inthe basic-level hospitals. Methods:120patients aged from66to78in Luzhipeople’s Hospital in Wuzhong District of Suzhou between October2011andDecember2013were chosen and randomized into three groups: noninvasivepositive pressure ventilation therapy group(group A), respiratory stimulanttreatment group (group B), noninvasive positive pressure ventilation withrespiratory stimulant therapy group (group C). Three groups of patients’clinical situation, breathing rate (RR), heart rate (HR), arterial blood oxygenpartial pressure (PaO2), pH, CO2partial pressure (PaCO2), and otherindicators were compared after4h,24h,72h and5d. The clinicalimprovement of the patients before and after treatment were concluded andAPACHE Ⅱ was scored. The tracheal intubation rate of patients, averagehospitalization days, average hospitalization expenses, mortality, and adversereactions were evaluated. Results:1, curative effect:(1) group A and group Care better than group B while there is no obvious differences between group Aand group C.(2) After72h, RR, HR in three groups were improved, but group A, C were improved significantly. After treatment of5d, RR, HR in group A,C were closely to the normal level. The improvement of Patients with arterialblood gas index (pH, PaO2, PaCO2) in group B is not obvious before andafter treatment, while patients with arterial blood gas index improvedsignificantly in group A, C, especially the improvement of PaCO2. However,there was no significant difference in the therapeutic effect between group Aand C.2, Outcome indicators: In group A, the effective rate was85%, themortality rate was7.5%, and the intubation rate was15%. In group B, theeffective rate was65%, mortality rate was15%, and the intubation rate was35%. In group C, the effective rate was87.5%, the mortality rate was5%, andthe intubation rate was12.5%. The above results show that the curative effectof using NIPPV to treat the old patients with AECOPD combined type IIrespiratory failure is obvious, but the NIPPV joint respiratory stimulantoverall treatment effect is not better than the effect of using NIPPV treatmentalone. Conclusion: Based on the “basic skills”,“fundamental condition”,“basic personnel” of the basic-level hospitals, the curative effect of treatingthe old patients with AECOPD combined type II respiratory failure is obvious.It effectively reduces the mortality rate, and save medical resources. Becausethe old patients with AECOPD are more in the basic-level hospitals, it isworthwhile to promote and improve the NIPPV technology, which benefitsthe reasonable allocation of social medical resources.