Effect of different stress levels noninvasive mask BiPAP ventilation in the treatment of AECOPD with type Ⅱ respiratory failure / 中国基层医药

ABSTRACT

Objective To analyze the effect of different stress levels noninvasive mask BiPAP ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with type Ⅱ respiratory failure.Methods From January 2015 to June 2017,120 patients of AECOPD with type Ⅱ respiratory failure in Jincheng People's Hospital were randomly divided into three groups by the random number table,with 40 cases in each group.The suction pressure of A group was set to 10-14cmH2O.The suction pressure of B group was set to 15-19cmH2O,while the suction pressure of C group was set to 20-25cmH2O.The clinical curative effect of three groups was compared.Results The PaO2 level of three time points among the three groups were compared by repeated measurements of variance.The results showed that after treatment for 24h,the PaO2 levels of A group,B group and C group were (57.15 ± 5.03) mmHg,(60.28±5.21) mmHg and (58.38 ± 6.06) mmHg,respectively.After treatment for 72h,the PaO2 levels of A group,B group and C group were (63.02 ± 6.08) mmHg,(80.16 ± 5.28) mmHg and (70.07 ± 5.23)mmHg,respectively.After treatment for 168h,the PaO2 levels of A group,B group and C group were (70.11 ±60.28)mmHg,(86.35 ± 5.01) mmHg,(79.26 ±5.16) mmHg,respectively.The results showed that the difference in PaO2 of different groups was statistically significant (F =8.514,P ＜0.001),and there was significant difference in PaO2 at different time points (F =13.681,P ＜ 0.001),and there was interaction between groups (different processing formulas) and time points (F =9.872,P ＜ 0.001).There was an interaction between PaCO2 and PaO2/FiO2 in the groups and time points (P ＜ 0.001).The rank sum test was used to compare the curative effect among the three groups.The Z value was 17.512 (P ＜0.001),and the comparison with the cutting probability method showed that the effective rate of B group was significantly higher than that of A group and C group (P ＜ 0.012).Conclusion 15-19cmH2O inhalation pressure can significantly improve the effect of non invasive mask BiPAP treatment for AECOPD with type Ⅱ respiratory failure,and the improvement of blood gas index is better with time.