Based On The Comprehensive Treatment Of Noninvasive Positive Pressure Ventilation In The Treatment Of Chronic Obstructive Pulmonary Disease With Respiratory Failure Curative Effect Of Meta Analysis

Objective:1 Review of lung distension research this paper discusses the origin and the etiology of the disease,combined with modern medical research to identify the disease according to different period,Summarize this disease of the research situation and problem solving in TCM.2 Through the system evaluation of noninvasive positive pressure ventilation on chronic obstructive pulmonary disease with respiratory failure RCTs research,to study the efficacy of noninvasive positive pressure ventilation for patients and clinical value,in order to provide reference for subsequent clinical research and practice.Methods:1 Base on CNKI?TC-MCD?TCM database system to advanced for pulmonary distension disease,obtain relevant literature,carry on the theoretical review summary.2For the study of the treatment of COPD with respiratory failure,on the basisofretrievalstrategy,keywordsretrievalstrategyisusedto?1?"noninvasivepositivepressureventilation"subjectheadings,respectively,and contain the keywords?2?"chronic obstructive pulmonary disease"?3?"Respiratoryfailure"?4?"random”basedontheretrieval strategy,the databases of TCMDB,Wan Fang Database,CNKI,CBM,CSCD,Pub Med,EMBASE.com and Cochrane Library,from database foundation to February 2017,and conference papers,grey literatures included were retrieved,to acquire all the RCTs about the COPD with respiratory failure.In accordance with theformulated inclusion criteriaandexclusion standards,the eligibleliteratrues were selected and the data were extracted.All patients were clear diagnosis of chronic obstructive pulmonary disease with respiratory failure;Control group using conventional treatment?anti-infection,eliminating phlegm,relieving asthma,hormone,low-flow oxygen and supply treatment keeping water electrolyte disorder such as nutritionalsupportfoundationtreatment?.Inaccordancewiththe formulated into and exclusion standard screening qualified documents.Use Endnote X7 to delete the filtered literature,get the research data and quality evaluation.Rev Man5.3 software was applied to noninvasive positive pressure ventilation outcome indexes were analyzed.Result:The retrieved 9346 references,eventually into 127 references and10556 patients.1 According to the results included in the study,the control group was 5256and the NIPPV intervention group was 5300.All documents refer to random,100%described the integrity of the data and the cause of the loss;63.4%are described in detail and exclusion criteria;100%above the statistical method.2 Meta-analysis showed:the effective of NIPPV in chronic obstructive pulmonary disease with respiratory failure:Z=8.23,OR=3.44,95%CI[2.57,4.62]?P<0.00001?;Airway intubation curative effect influence:Z=9.60,OR=0.29,95%CI[0.22,0.37]?P<0.00001?;Hospitalization days impact MD=-7.98[-9.40,-6.55];MortalityrateimpactZ=5.34,OR=0.43[0.32,0.59]?P<0.00001?;Show that NIPPV intervention group in effectiveness,reduce the rate of endotracheal intubation,hospitalization days,the mortality rate is superior to conventional treatment groups;p H effect in blood gas analysis:Z=10.73,MD=0.05,95%CI[0.04,0.06]?P<0.00001?;Pa CO₂in blood gas analysis therapeutic effects Z=15.32,SMD=-1.48[-1.67,-1.29]?P<0.00001?;Pa O₂ in blood gas analysis therapeutic effects Z=16.50,SMD=1.65[1.45,1.85]?P<0.00001?;Impact on the RR:Z=16.03,MD=-4.85,95%CI[-5.54,-4.26]?P<0.00001?;Impact on the HR:Z=14.55,MD=-10.47,95%CI[-11.88,-9.06]?P<0.00001?;Impact on the Sa O₂:Z=5.22,MD=6.79,95%CI[4.24,9.34]?P<0.00001?;therapeutic effectsin FEV₁%:Z=5.04,MD=10.34[6.32,14.37]?P<0.00001?;therapeutic effects in FEV₁/FVC Z=4.22,MD=6.57[3.52,9.62]?P<0.00001?remained statistically significant.Indicating that NIPPV in blood gas analysis?RR?HR?oxygenation?pulmonary function improvement is better than the conventional control group.Conclusion:1This research have preliminary confirmed noninvasive positive pressure ventilation can improve chronic obstructive pulmonary disease with respiratory failure period curative effect to correctly evaluate the treatment of NIPPV,revise individual RCT findings and provide evidence support.2 Noninvasive positive pressure ventilation can improve chronic obstructive pulmonary disease with respiratory failure condition,to reduce the CO2 retention,andimproving the hypoxia state of the patient,to reduce the heart rate,alleviate symptoms of chest tightness,make life in stable condition.And NIPPV also for Clinical applications provide preliminary evidence,in reduce the endotracheal intubation rate as well as shorten the length of hospital stay,reduce the case fatality rate,etc.It is a preliminary evidence-based evidence is provided for the clinical application of NIPPV for lungdistension.3 Noninvasive positive pressure ventilation can be used as a clinical routine treatment for chronic obstructive pulmonary disease combined with respiratory failure.