Efficacy Analysis Of Non-invasive Positive Pressure Ventilation With Different Pressures On AECOPD Combined With Type Ⅱ Respiratory Failure

Objective:by observing the acute exacerbation of chronic obstructive pulmonary disease（AECOPD）period patients combined with type II respiratory failure before treatment and after treatment of 2 h,24 h,72 h the changes of Pa O₂,Pa CO₂,p H value with different pressure levels noninvasive ventilation and adverse reactions,mortality,length of hospital stay to analyse the clinical curative effect on different stress levels noninvasive ventilation in AECOPD patients with type II respiratory failure.Methods:Eighty patients with AECOPD complicated with type II respiratory failure hospitalized in the Department of Respiratory Medicine of our Hospital from December 2019 to February 2021 were selected and divided into two groups-high pressure ventilation group and low pressure ventilation group,with40 patients in each group.Both groups received routine treatment,including oxygen inhalation,airway dilatation,anti-infection,nutritional support and other symptomatic treatment.All patients were treated with ventilators,and wore Appropriate nasal mask which was made according to their facial comfort,and the doctors fixed examined if there was air leakage in the ventilator mask on time.The ventilator was set as ST mode,oxygen concentration was 3-4 mmol/L,the parameters of low pressure ventilation group were set as IPAP:12-16 cm H₂O,EPAP:3-4 cm H₂O;the parameters of high pressure ventilation group were set as IPAP:20-24 cm H₂O,EPAP:3-4 cm H₂O;the respiratory rate was 15 breaths/min,each ventilation for 4h,3 times a day.Pa O₂,Pa CO₂ and p H values were detected and recorded before treatment and 2 h,24 h and 72 h after noninvasive ventilation,as well as the hospitalization time,mortality,gastrointestinal flatulence,mask compression skin injury and other adverse reactions of the two groups.Results:1.There was no difference in the general information of patients（age,gender,course of disease,height,weight and other basic information）between the two groups（P>0.05）,the study is indicating comparability.2.There were no significant differences in Pa O₂,Pa CO₂ and p H values between the two groups before treatment with non-invasive positive pressure ventilation（P>0.05）.3.After treatment with non-invasive positive pressure ventilation,the blood gas Pa O₂ value of both groups increased significantly compared with that before treatment,and the difference was statistically significant（P<0.05）.Compared the high pressure group with the low pressure group at the same time,the blood gas Pa O₂ value of the high pressure group increased more obviously,and it is statistically significant.（P<0.05）.4.Pa CO₂ of blood gas in both groups decreased significantly after non-invasive positive pressure ventilation treatment and before treatment,with statistical significance（P<0.05）.Pa CO₂ of the high pressure group decreased more obviously at the same time,with statistical significance（P<0.05）.5.Before and after treatment with non-invasive positive pressure ventilation,the p H value of blood gas in both groups increased,the difference being statistically significant（P<0.05）.Compared with the same time between the high pressure group and the low pressure group,the p H value of the high pressure group increased more obviously,the difference being statistically significant（P<0.05）.6.The length of stay in the high pressure group was shorter than that in the low pressure group,and the difference was statistically significant（P<0.05）,but there was no statistically significant difference in the mortality rate and the incidence of adverse reactions between the two groups（P>0.05）.Conclusion:Compared with low pressure,high pressure non-invasive positive pressure ventilation in the treatment of AECOPD with type II respiratory failure can more effectively improve the blood gas analysis results and shorten the length of hospital stay,but it can not reduce the mortality rate,nor decrease the incidence of adverse reactions.