The Analysis On The Therapeutic Effect Of NPPV In AECOPD Patients With Different Degrees Of Respiratory Acidosis

Objectives: To treat the patients of AECOPD with different degrees of respiratory acidosis through NPPV.Comparing the results of arterial blood gas,heart rate,respiratory rate,clinical efficacy,the change of the scale scores among the three groups patients before and follow NPPV therapy.To explore the effects of NPPV in AECOPD patients with different degrees of respiratory acidosis.Methods: Selection 90 patients of AECOPD combined with respiratory acidosis,all the cases were recruited in the three respiratory departments of Yanan University Affiliated Hospital from February 2014 to December 2016.90 cases of AECOPD patients were divided into three groups : group A: mild respiratory acidosis(PH?7.35);group B:moderate respiratory acidosis(7.25 ?p H<7.35);group C:severe respiratory acidosis(p H < 7.25);Each group has 30 cases;Three groups were all given early application of NPPV combined medications,the before and follow treatment of 2h,24 h,72h in HR,RR,Pa O2,Pa CO2,Sa O2 as well as clinical effectiveness and scale scores(VAS,SAMU,CAPS scale)were recorded and statistically analyzed.By doing this,we intend to get clinical evaluation of efficacy of NPPV in different degrees of respiratory acidosis.Results:1.From the analysis of baseline information: Compared group C with group A and B was found that Age,RR,HR,Pa CO2,Pa O2,Sa O2 and CAPS score had significant difference(P<0.05).The data of group A,B were not statistically difference except Pa CO2,HR,RR.The VAS score and SAMU score of three groups were high,but there were not statistically difference(P>0.05).2.From the analysis of the physiological indexes: The three group after 72 hours' NPPV treatment compared with before treatment was found HR,RR all had significant difference(P<0.05).Compared the degree of improvement of three group were C>B>A,and the degree of improvement was gradually decreased with the extension of the time.3.From the analysis of the arterial blood gas results: For the group A,PH,Pa CO2 follow 2h and 24 h treatment was not statistically difference(P>0.05),but follow treatment of 72 h,compared with before treatment,Pa CO2 of group A also had significant difference(P<0.05).The group B and group C follow treatment of 72 h,compared with before treatment was found Pa CO2,PH,Pa O2,Sa O2 all had significant difference(P<0.05).The group C can quickly improve PH and make Pa CO2 decline in a short time(follow treatment of 2h).Compared with group C and group B,we also found the group A had faster rate of improvement and higher Pa O2,Sa O2 follow treatment of 72 h,the changes of the above index had significant difference(P<0.05).4.From the analysis of the scale scores: The baseline of VAS score and SAMU score of three groups were not statistically difference(P>0.05).The three group follow treatment compared with before treatment were found that VAS score,SAMU score and CAPS score all had significant difference(P<0.05),and for the decline degree of CAPS score,group C was the most significant(P<0.05).5.From the analysis of the effective rate: The effective rate of three groups was not statistically difference(P>0.05).Conclusion:1.NPPV can improve HR,RR of different levels of acidosis.And the more severe acidosis were,the more obvious improvement of HR,RR were.2.NPPV can improve Pa O2,PH,Sa O2 of different levels of acidosis.and improve the Pa CO2 of moderate respiratory acidosis and severe respiratory acidosis.But for the mild acidosis,Pa CO2 can not improve in the treatment of 24 h,but Pa CO2 can get improve follow the treatment of 72 h.3.NPPV significantly reduced the symptoms of dyspnea and the work of breathing(WOB),alleviated respiratory muscle dysfunction in the treatment of AECOPD with different degrees of respiratory acidosis.4.NPPV also reduced the hospital mortality for each group,for this function,severe respiratory acidosis was the most effective.5.There is no obvious difference of the effective rate in the treatment among three groups.