Therapeutic Effect Of Early Applying NPPV In The Treatment Of AECOPD Combined With Type Ⅱ Respiratory Failure

Objectives: Observing the early application of NPPV in the treatment of AECOPD associated with type II respiratory failure patients in symptoms, heart rate, arterial blood gas, respiratory rate, oxygen saturation and other improvements, we attempt to explore the clinical curative effect of this kind of treatment as well as the impact on the patients’ hospitalization days, cost of hospitalization.Methods:We select 60 cases of patients who are all diagnosed with AECOPD associated with type II respiratory failure at department of respiratory and geriatrics in Yan’an University Affiliated Hospital from January 2014 to January 2016 years, whose age at 56-88 years(average 73.9±9.4 years) and history of COPD are ranging from 5 to 30years(average 15.81±607 years). Application of noninvasive positive pressure ventilation combined with conventional medical treatment of 30 patients are arranged as treatment group(the group of A), including 16 males and 14 females, with average age of 73±9.5 years(range: 57-87 years). And the other 30 cases treated with conventional medical treatment(antibiotics, oxygen, glucocorticoid therapy) patients are as control group(the group of B), of which 19 males and 11 females, aged 56-88 years, mean age( 74 ± 9.6) years. We intend to get the early clinical evaluation of the efficacy of the combination of NPPV, through comparing two groups of patients before and after treatment of 24 h, 72 h in HR, RR, Sa O2, p H, Pa O2, Pa CO2, CAT score as well as the patients’ average hospital costs and length of hospital stay.Results:1. The group of A after treatment of 24 h, compared with before treatment was found that Pa O2, HR, Sa O2, RR, p H and Pa CO2 had significant difference(P < 0.05), the CAT score was not statistically difference(P > 0.05). After treatment of 72 h, compared with before treatment, the changes of the above indexes had significant difference(P < 0.05).2. The group of B after treatment of 24 h, compared with before treatment was found that Pa O2, HR, Sa O2, RR were statistical difference(P < 0.05), while the scores of CAT, p H, Pa CO2 was not statistically different(P>0.05).After treatment of 24 h,compared with before treatment, the above indexes were statistically difference(P < 0.05).3. The comparison of patients in the group of A and B after the treatment of 24 h revealing that the changes of the group of A were significantly more than that of the group of B, namely, the two groups( A and B) were significant difference in HR, Sa O2, p H, Pa O2, Pa CO2, RR(P all< 0.05). But the CAT score was not statistically different(P > 0.05); after treatment of 72 h, all indexes of the two groups were statistically difference(P < 0.05).4. By comparing the average hospitalization expenses and hospitalization days between the group of A and B, we found the average hospitalization expenses and hospitalization days in the group of A were significantly lower than that in the group of B, showing statistical difference(P < 0.05).Conclusions:1. Early combined application of NPPV in the treatment of AECOPD associated with type II respiratory failure was more effective significantly than conventional medical treatment, which can timely and effectively improve patients’ p H, Pa O2, Pa CO2, SO2, RR, SO2, HR, CAT score.2. Early combined application of NPPV in the treatment of AECOPD associated with type II respiratory failure was more economical than conventional treatment for patients, which can reduce the hospitalization days and hospitalization expenses.