Analysis Of The Cure Effect Of Home Non-invasive Ventilation To The Patients With Chronic Obstructive Pulmonary Disease Complicated With ? Respiratory Failure In Stable Stage

Objective: To investigate the effect of noninvasive ventilation on the treatment and prognosis of patients with chronic obstructive pulmonary disease?COPD?complicated with type ? respiratory failure in stable stage.Methods: Eighty cases of patients with COPD complicated with type II respiratory failure from December 2014 to January 2016 were studied in the Second Central Hospital of Baoding,the pulmonary function test showed that the lung function were severe and extremely severe when the condition was stable.The blood gas analysis suggested that type ? respiratory failure,Forty patients were randomly selected as the noninvasive group,and continued to be treated with noninvasive ventilator after discharge.Another forty patients as oxygen therapy group,and continued to be given continuous low flow oxygen.To observe the Blood parameters,lung function,BODE index,6-minute walking distance test?6MWD?,CAT score,m MRC score and hospitalization times on the 0 month,3^rd month and 6^th month after discharge.Results: The levels of Pa CO₂,Pa O₂,lung function,BODE index,6MWD,CAT score and m MRC score were not significantly different between noninvasive group and oxygen therapy group in terms of the basic condition at discharge?P>0.05?.The compare results of Pa CO₂,Pa O₂,lung function,BODE index,6MWD,CAT score,m MRC score and hospitalization times within 6 months after discharged were showed as follow:1 Noninvasive patients at the 3^rd month after discharged Pa CO₂60.04± 5.33 mm Hg was significantly improved compared with 0 month Pa CO₂65.85± 4.80 mm Hg?P=0.000?,Pa O₂83.93±27.31 mm Hg was no obvious change compared with 0 month Pa O₂75.95±12.76 mm Hg?P=0.098?;Noninvasive patients at the 6^th month after discharged Pa CO₂55.33±6.30 mm Hg was further improved compared with 3^rd month after discharged?P=0.000?,significantly improved compared with 0 month?P=0.003?.Oxygen therapy group patients at the 3^rd month after discharged Pa CO₂65.85±5.31 mm Hg was a slightly improved compared with 0 month Pa CO₂68.13±5.10 mm Hg?P=0.054?,Pa O₂75.16±9.39 mm Hg compared with 0 month Pa O₂71.15±10.82 mm Hg was improved?P=0.011?,Oxygen therapy group patients at the 6^th month after discharged,Pa CO₂ 66.15±5.50 mm Hg was not significantly improved?P=0.783?compared than the 3^rd month,Pa O₂76.15±10.82 mm Hg compared with 3^rd month after discharged was not significantly improved?P=0.563?;Pa CO₂ was slightly improved?P=0.105?,Pa O₂ was significant improved?P=0.008?;Pa CO₂ in noninvasive group at the 3^rd month after discharged was lower compared with oxygen therapy group,Pa O₂ was higher than in oxygen therapy group?they were respectively P=0.000,P =0.003?;Pa CO₂ and Pa O₂ in noninvasive group at the 6^th month after discharged were significantly improved compared with oxygen therapy group?both of the two P=0.000?.2 Noninvasive group patients at the 3^rd month after discharged lung function showed FEV1 48.66±11.35 L was not improved compared with 0 month FEV1 44.9±10.31L?P=0.125?,FVC64.75±7.89 L was no improved compared with 0 month FVC64.54±7.67L?P=0.903?,FEV1/ FVC59.03± 8.80% was not improved compared with 0 month FEV1/ FVC58.80±8.44%?P=0.905?;Noninvasive patients at the 6^th month after discharged lung function showed FEV151.18±11.45 L was not improved compared with 3^rd month after discharged?P=0.327?,a little improved compared with 0 moth?P=0.012?,FVC65.15±8.26 L was not improved compared with 3^rd month and 0 month after discharged?they are respectively P= 0.830,P=0.734?.FEV1/ FVC59.15±9.10% was not improved compared with 3^rd month and 0 month after discharged?they are respectively P= 0.953,P=0.858?.Oxygen therapy group patients at the 3^rd month after discharge lung function showed FEV1 39.57±9.45 L was not improved compared with 0 month after discharged FEV1 40.61±9.55 L,?P=0.626?,FVC60.80±9.42 L was not improved compared with 0 month after discharged FVC61.64±9.09L?P=0.685?,FEV1/FVC50.32±9.70% was not improved compared with 0 month after discharged FEV1/ FVC51.79±9.78?P=0.658?;Oxygen therapy group patients at the 6^th month after discharge lung function showed FEV1 38.27±9.51 L was not improved compared with 3^rd month and 0 month after discharged?they are respectively P= 0.543,P=0.277?,FVC59.69±9.77 L was not improved compared with 3^rd month and 0 month after discharged?they are respectively P= 0.609,P=0.359?,FEV1/ FVC49.47±9.57% was not improved compared with 3^rd month and 0 month after discharged?they are respectively P= 0.691,P=0.401?.Noninvasive group patients at the 3^rd month after discharged lung function showed FEV1?FVC?FEV1/ FVC were all higher than the Oxygen therapy group patients?they are respectively P= 0.000,P=0.031,P=0.000?.Noninvasive group patients at the 6^th month after discharge showed FEV1?FVC?FEV1/ FVC were significantly improved than the Oxygen therapy group patients?they are respectively P= 0.000,P=0.013,P=0.000?.3 Noninvasive group patients at the 3^rd month after discharged BODE index showed 3.83±2.32 was not improved compared with 0 month?P=0.121?,6-minute walking distance test showed 275.12±110.07 M was not improved compared with 0 month 263.48±110.07M?P=0.638?;Noninvasive group patients at the 6^th month after discharged BODE index showed 3.40±2.36 was not improved compared with 3^rd month after discharged?P=0.419?,was improved compared with 0 month?P=0.022?,6-minute walking distance test showed 284.74±104.86 M was not improved compared with 3^rd month and 0 month after discharged?they are respectively P= 0.690,P=0.379?.Oxygen therapy group patients at the 3^rd month after discharged BODE index showed 5.03±2.38 was not improved compared with 0 month?P=0.628?,6-minute walking distance test showed 226.99±106.20 M was not improved compared with 0 month 226.92±106.33M?P=0.998?;Oxygen therapy group patients at the 6^th month after discharged BODE index showed 4.98±2.476 was not improved compared with 3^rd month and 0 month after discharged?they are respectively P= 0.927,P=0.569?,6-minute walking distance test showed 229.01±109.57 M was not improved compared with 3^rd month and 0 month after discharged?they are respectively P= 0.934,P=0.931?.Noninvasive group patients at the 3^rd month after discharged BODE index was improved than the Oxygen therapy group patients?P=0.025?,Noninvasive group patients 6-minute walking distance test was not improved than the Oxygen therapy group patients?P=0.050?;Noninvasive group patients at the 6^th month after discharged the BODE index and 6-minute walking distance test were both significantly improved than the Oxygen therapy group patients?they are respectively P=0.005,P=0.023?.4 Noninvasive group patients at the 3^rd month after discharged CAT score 19.25±5.84 was improved compared with 0 month 22.08±6.38?P=0.042?,m MRC score 1.98±0.95 was improved compared with 0 month2.80±0.63?P=0.001?;Noninvasive group patients at the 6^th month after discharged CAT score 15.58±5.80 was further improved compared with 3^rd month after discharged?P=0.006?,m MRC score1.33±1.12 was more obviously improved compared with 3^rd month after discharged?P=0.006?.Oxygen therapy group patients at the 3^rd month after discharged CAT score 19.98±6.33 was not improved compared with 0 month 21.53±5.51?P=0.246?,m MRC score 2.08±0.83 was not improved compared with 0 month 2.33±0.62?P=0.130?;Oxygen therapy group patients at the 6^th month after discharged CAT score 19.53±7.74 was not improved compared with the 3^rd month and 0 month after discharged?they are respectively P= 0.777,P=0.187?,m MRC score 1.75±1.08 was not improved compared with 3^rd month after discharged?P=0.135?,was improved compared with 0 month?P=0.005?.Noninvasive group patients at the 3^rd month after discharged CAT score and m MRC score were not significantly different from Oxygen therapy group patients?they are respectively P=0.596,P=0.617?,Noninvasive group patients at the 6^th month after discharged CAT score was improved compared with Oxygen therapy group patients?P=0.012?,m MRC score was not improved compared with Oxygen therapy group patients?P=0.088?.5 The hospitalization times of Noninvasive group patients was significantly reduced within 6 months after discharged compared with Oxygen therapy group patients?P=0.019?.Conclusion: 1 The long-time home noninvasive ventilation can improve Pa O₂ and m MRC score of the patients with chronic obstructive pulmonary disease?COPD?combined with II respiratory failure in stable stage.There was no obvious improvement on Pa CO₂,lung function,BODE index,6-minute walking distance test and CAT score.2 After application of the home non-invasive positive pressure ventilation,it can improve the Pa O₂,Pa CO₂,FEV1,BODE,CAT score,m MRC score and reduce the hospitalization times,but it can't improve the 6 min of walking distance.3 The home non-invasive positive pressure ventilation is more effective on improving Pa CO₂,lung function,BODE,CAT score,m MRC score,it is a strong tool for the patients with II respiratory failure in clinical treatment.