Effectiveness Of Noninvasive Positive Pressure Ventilation In AECOPD Complicated With Type ? Respiratory Failure

Objective: Explore the clinical efficacy of Noninvasive Positive Pressure Ventilation in AECOPD(the acute exacerbation of chronic obstructive pulmonary disease)complicated with type ? respiratory failure.We want to seek for some evidence for guiding clinical treatment.Methods: Fifty patients with type?respiratory failure of acute exacerbation of chronic obstructive pulmonary disease from January in 2014 to December in 2015 in our hospital were included in the study.Of them,27 patients received contrast group(with conventional therapy,including oxygen,infection control,cough sputum interest,antispasmodic asthma,correct electrolyte imbalance),16 were men,while 11 were women.Another 23 patients received NPPV group(with conventional therapy and Noninvasive Positive Pressure Ventilation),15 were men,while 8 were women.The patients of two group tested by statistical methods to age,gender,course,smoking index,APCHE?,m MRC,ALB,WBC,HR,RR,PH,Pa O2,Pa CO2,SO2,there is no obvious difference before treatment(P > 0.05).Compare the HR,RR,PH,Pa O2,Pa CO2,the average days stay in the hospital,the death rate,and trachea intubation rate between the two groups after treat.Results :There was marked difference in blood gas indexes(including PH,PaO2,Pa CO2,SO2)in NPPV group before the treatment and after 72 hours treatment(P<0.05).There was no marked difference in PH and Pa CO2 level in contrast group before the treatment and after 72 hours treatment(P>0.05),but there was marked difference in SO2 and Pa O2 level(P<0.05).There was marked difference in blood gas indexes andvital signs(including PH,Pa O2,Pa CO2,SO2,RR,HR)in the two groups before the treatment and after the treatment(P<0.05).There was marked difference in blood gas indexes and vital signs between the two groups(P<0.05).It is important to NPPV group better than contrast group.There were three cases in the NPPV group did not ease,two case of them were given trachea cannel and one case died at last,one case refused to receive invasive ventilation and died at last.There were seven cases in the contrast group did not ease,one cases of them refused to receive ventilation treatment and get and died at last,six cases of them receive noninvasive positive pressure ventilation,three cases get better,one case died,another two cases case were given trachea cannel and died at last.Between NPPV group and contrast group,the average days stay in the hospital were 12.21±4.31 days and 16.25±5.79 days,the death rate were 8.70% and14.87%,the trachea intubation rate were 8.70% and 11.11%.The NPPV group significantly reduced the mean hospital stay(P<0.05).There was no marked difference in the death rate,trachea intubation rate between the two groups(P>0.05).Conclusion:1.The results suggest that in AECOPD patients with type II respiratory failure,NPPV is effective for most of the patients.2.The results suggest that NPPV can improve the blood gas indexes(PH,Pa O2,Pa CO2,SO2)and vital signs(RR,HR),use less time to improving PH,Pa CO2 in the patients with AECOPD complicated with Type?Respiratory Failure,reduce the average days stay in the hospital.