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Objective To study the clinical application value of long term home noninvasive positive pressure ventilation in the therapy of silicosis patients with type 2 respiratory failure. Methods A total of 85 silicosis patients with type 2 respiratory failure were enrolled, and their clinical data were retrospectively analyzed. According to the therapeutic method, they were divided into noninvasive positive pressure ventilation group (group A) and basic therapy group (group B). The various indicators of the patients were analyzed before and after the treatment including vital signs, laboratory indicators, 6-minute walking distance (6MWD), and modified dyspnea index (mMRC). The admission times, length of hospital stay and annual mortality of the patients were also recorded by follow-up after the treatment for one year. Results After the one year follow-up, the heart rate, respiratory rate, PaO2, PaCO2, SO2％, 6MWD, and mMRC of group A were significantly improved than those of group B (all P<0.05). The admission times and the length of hospital stay of group A were lower than those group B (all P<0.05). There was no difference in the annual mortality between the two groups (P>0.05). Conclusions The therapeutic method of home noninvasive positive pressure ventilation has significant effects on silicosis combined with type 2 respiratory failure. It can improve clinical symptoms and the quality of life, and reduce the length of hospital stay and admission times, and reduced medical insurance burden.
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Objective: To compare the efficacy and safety between humidified high flow nasal cannula (HHFNC) and noninvasive positive pressure ventilation (NPPV) in patients with chronic obstructive pulmonary disease (COPD) complicated with type 2 respiratory failure after extubation. Methods: Seventy-two patients with COPD complicated with type 2 respiratory failure were enrolled after extubation and were randomized into HHFNC group and NPPV group at 1: 1 ratio, with 36 patients in each group. The blood gas analysis index, respiratory rate, heart rate, mean arterial pressure, reintubation rate, incidence of tracheotomy, intensive care unit stay, incidence of adverse events and mortality were compared between the two groups before treatment and 2, 12, 24 h after treatment. Results: The pH at 24 h, partial pressure of oxygen in artery (PaO2) at 2 h and 12 h, and oxygenation index (PaO2/FiO2) at 2 h and 12 h after treatment were significantly higher in the HHFNC group compared with the NPPV group (all P0.05), while the overall incidence of adverse events, intolerance rate, flatulence rate and aspiration rate were significantly lower in the HHFNC group than those in the NPPV group (all P 0.05). Conclusion: The short-time efficacy and safety of HHFNC are better than NPPV in treatment of COPD complicated with type 2 respiratory failure.
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Objective:To analyze the clinical efficacy of Seretide combined with noninvasive positive pressure ventilation (NIPPV) in the treatment of chronic obstructive pulmonary disease (COPD) complicated with type 2 respiratory failure (RF).Methods:120 patients of COPD complicated with type 2 RF were randomly divided into the observation group and the control group.All patients were treated with routine,symptomatic and supportive treatment,based on that NIPPV was used in the control group,and the observation group was treated with Seretide on the basis of NIPPV.The levels of arterial blood gas,inflammatory factors,pulmonary function and CAPS score before and after treatment were compared and analyzed.Results:After treatment,the pH,PaO2 and SaO2 of both groups were significantly increased,PaCO2 levels weresignificantly decreased,serum IL-33,TNF-oα and sICAM-1 levels were significantly decreased,FVC,PEFR,FEV1％ and FEV1/FVC were significantly decreased,and the CAPS scores were significantly decreased;the changes of all the index mentioned above in the observation group were more statistically significant (P＜0.05).Conclusion:Seretide com bined with NIPPV could more effectively decrease the levels of inflammatory factors and improve the blood gas and lung function in the patients of COPD with type 2 respiratory failure.
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Objective To investigate the prognosis value of pulmonary infection score and acute physiology and chronic health evaluation to acute exacerbation of COPD with type 2 respiratory failure. Methods 112 cases with acute exacer-bation of COPD with type 2 respiratory failure were selected as research subjects in our hospital from February 2011 to February 2014,scores of two scoring methods,actual mortality with different scores of two scoring methods,ROC curve predicted mortality of two scoring methods to chronic obstructive pulmonary disease with acute exacerbation of respira-tory failure of survival group and death group were compared. Results There were no significant differences between the two groups in PaO2、pH、PaCO2 and HCO3-(t=1.742, 1.647, 1.791, 1.082, P>0.05);but the levels of AG and poten-tial HCO3-in death group were higher than those in survival group(t=10.865, 5.993, P<0.05). APACHEⅢ,CPIS scores of survival group significantly were lower than the death group, the differences were statistically significant (t=6.254,4.397,P<0.05). Mortality of APACHⅢ score ≥25 and CPIS score ≥6 were significantly higher than patients with lower than that value, the differences were statistically significant(χ2=10.264,7.351,P<0.05). CPIS predict mortality acute exacerbation of COPD with type 2 respiratory failure, the area under the ROC curve was 0.867,APACHEⅢpredict mortality acute exacerbation of COPD with type 2 respiratory failure, the area under the ROC curve was 0.938. Conclusion CPIS and APACHEⅢ has certain prognostic value to acute exacerbation of COPD and type 2 respiratory failure,but APACHEⅢ resolution are better, it can provide a reference for disease prediction, it is worthy of applica-tion and promotion in clinical.