双水平气道正压通气联合舒利迭对老年中重度慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者生活质量的影响

目的探讨双水平气道正压通气（BiPAP）联合舒利迭对老年中重度慢性阻塞性肺疾病（COPD）合并Ⅱ型呼吸衰竭患者生活质量的影响。方法将80例老年中重度COPD合并Ⅱ型呼吸衰竭患者随机分为观察组（40例）和对照组（40例），两组均给予常规抗感染、吸氧、解痉平喘、祛痰等常规治疗，并采用BiPAP呼吸机进行辅助通气治疗。观察组在此基础上吸人舒利迭治疗。比较治疗前及治疗后7d的动脉血气主要指标、治疗前及治疗后7d及3、6个月的肺功能及生活质量评价结果（SQGR评分）。结果治疗前、后两组动脉血气主要指标、肺功能主要指标、SQGR评分比较差异均有统计学意义（P均〈0．01），其中观察组治疗后7dPaCO：显著低于对照组（42．9±7．9）mmHg与（47．6±8．0）mmHg，t=8．467，P〈0．001]。两组1秒用力呼气容积在治疗后3、6个月与治疗后7d比较差异均无统计学意义（P均〉0．05）。两组1秒用力呼气容积／用力肺活量在治疗后3、6个月分别与治疗后7d比较差异均有统计学意义治疗组：（49．9±5．1）％与（47．1±4．2）％，（50．2±5．0）％与（47．1±4．2）％；对照组：（49．0±5．4）％与（46．6±5．9）％，（49．8±5．2）％与（46．6±5．9）％；P均〈0．05]。观察组治疗后6个月SQGR评分显著低于治疗后7d（40．8±8．5）分与（45．9±10．8）分，P〈0．05]，并显著低于对照组治疗后6个月的SQGR评分（40．8±8．5）分与（46．0±8．0）分，P〈0．05]。结论BiPAP联合吸入舒利迭治疗中重度COPD合并Ⅱ型呼吸衰竭效果较好，能改善肺功能并提高患者的生活质量。

Effect of Bi-level positive airway pressure ventilation combined with Seretide on quality of life of elder I patients with moderate and severe chronic obstructive pulmonary disease and type II respiratory failure

Objective To investigate the effect of Bi-level positive airway pressure ventilation （BiPAP） combined with Seretide on quality of life of elder patients with moderate and severe chronic obstructive pulmonary disease （COPD） and type H respiratory failure. Methods Eighty elderly patients with moderate to severe COPD and type H r ：spiratory failure were selected and randomly divided into observation group （n = 40） and control group（n = 461. The two groups were given conventional anti infection, oxygen inhalation, spasmolysis, expectorant and otheconventional treatment, and the use of BiPAP ventilator assisted ventilation. Patients in observation group were administered the combined of Seretide and BiPAP treatment, and patients in control werereceived only BiPAP. Arterial blood gases before and after 7 d treatment, lung function and quality of life evaluation results （SQGR score） before and after 7 d,3 months and 6 months treatment,were measured. Results There were significant differences in terms of arterial blood gases, pulmonary function key indicators, SQGR score between two groups before and after treatment（ P 〈 0. 01 ）. PaCO2 was significantly after 7 d of treatment in observed group was （42. 9 ± 7.9） mmHg, lower than that of the control group （ （47.6 ± 8. 0） mmHg; t = 8. 467, P 〈0. 001 ）. There was no significant difference in terms of forced expiratory volume in one second（ FEV1 ） in both groups at 7 d,3 months,6 months after treatment （P 〉 0. 05 ）. FEV1/forced vital capacity （FVC） in two group at 3 months,6 months after treatment were different compared to 7 d after treatment （observation group： （49.9 ±5. 1）% and （47.1±4.2）%,（50.2±5.0）% and（47.1 ~4.2）% ;controlgroup：（49.0±5.4）% and （46. 6 ± 5.9） %, （49. 8 ± 5.2） % and （46. 6 ± 5.9 ） % ; P 〈 0. 05 ）. SQGR score in observation group at six months after treatment were （40. 8 ± 8. 5 ）, significantly lower than that of 7 d after treatment（45.9 ± 10. 8 ）, P 〈 0. 05）, mad significantly lower than the control group after 6 months of treatment （ （40. 8 ± 8.5 ） vs （46.0 ± 8.0 ）, P 〈 0. 05 ）. Conclusion Seretide combined with BiPAP treatment can significant improve lung function and the quality of life of patients with moderate and severe COPD and type 11 respiratory failure.