Clinical Value Of Non-invasive Ventilator In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease Complicated With Type Ⅱ Respiratory Failure

Objective:Chronic obstructive pulmonary disease（COPD）is a common and frequently-occurring disease of the respiratory system,and the symptoms of patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）are more obvious and serious.Type II respiratory failure is one of the most common complications of AECOPD.To analyze the clinical value of non-invasive ventilator（NIV）assisted ventilation in patients with AECOPD complicated with type II respiratory failure,so as to provide better guidance for the clinical development of respiratory critical medicine in the future.Methods:The clinical data of AECOPD patients admitted to the Department of Respiratory and critical Care,the first affiliated Hospital of Dalian Medical University from September 2016 to November 2019 were retrospectively analyzed.According to the inclusion and exclusion criteria,101patients with AECOPD complicated with type II respiratory failure were divided into routine group（group A）and non-invasive group（group B）according to the use of non-invasive ventilator.The routine group was treated with general treatment（including oxygen inhalation,anti-infection,bronchodilator,expectorant,glucocorticoid,maintenance of electrolyte acid-base balance,etc.）,and the non-invasive group was treated with non-invasive ventilator-assisted ventilation on the basis of general treatment.By analyzing whether there are differences in age,sex,smoking history,course of COPD,underlying diseases,clinical manifestations,laboratory indicators,treatment methods,length of stay,times of hospitalization,cost of hospitalization,efficiency,tracheal intubation,case fatality rate and so on between the two groups.The data were analyzed by SPSS 21.0 software.Univariate analysis was performed by t-test and chi-square test.Paired t-test was used to compare the blood gas analysis before and after treatment.Results:1.A total of 101 patients with AECOPD complicated with type II respiratory failure were included in this study.There were 51 patients in group A,accounting for50.5%,50 patients in group B,accounting for 49.5%.2.Univariate analysis showed that there was no significant difference in age,sex,smoking history and COPD course between the two groups（P>0.05）.There was no significant difference in the history of coronary heart disease,diabetes,hypertension between the two groups（P>0.05）.3.There was no significant difference in PH、Pa CO₂、Pa O₂ and Sa O₂ between the two groups before treatment（P>0.05）.4.Compared with the blood gas analysis before and after treatment,there was significant difference in PH,Pa O₂ and Sa O₂ in group A（P<0.05）,but there was no significant difference in Pa CO₂（P>0.05）.There were significant differences in PH,Pa O₂,Pa CO₂ and Sa O₂ between pre-treatment and post-treatment in group B by paired sample t-test（P<0.05）.There was no significant difference in PH between group A and group B after treatment（P>0.05）,but there were significant differences in Pa O₂,Pa CO₂and Sa O₂ between the two groups after treatment（P<0.05）.5.There was no significant difference in hospitalization time between the two groups（P>0.05）.There were significant differences in hospitalization times and hospitalization costs between the two groups（P<0.05）.6.There was significant difference in the total effective rate between the two groups（P<0.05）.There was no significant difference in tracheal intubation and mortality between the two groups（P>0.05）.Conclusion:1.Compared with the non-invasive group（group B）,the routine group（group A）had more hospitalization times and higher hospitalization expenses.2.For the patients with AECOPD complicated with type II respiratory failure,the effect of non-invasive ventilator-assisted ventilation is better than that of conventional therapy.3.Non-invasive ventilator-assisted ventilation in the treatment of AECOD patients with type II respiratory failure can better improve the blood gas analysis index and alleviate the clinical symptoms of the patients.4.As an effective supportive therapy,non-invasive ventilator-assisted ventilation has high clinical value in the treatment of AECOPD patients with type II respiratory failure.