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Application effect of noninvasive ventilator combined with Tiotropium Bromide in elderly patients with acute exacerbation of chronic obstructive pulmonary disease complicated with type Ⅱrespiratory failure |
WANG Zhen LUO Zhongming SHU Dan GONG Wei |
Department of Emergency, Guangxin District People′s Hospital |
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Abstract Objective To investigate the effect of noninvasive ventilator combined with Tiotropium Bromide in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 124 patients with acute exacerbation of COPD complicated with type Ⅱrespiratory failure treated in Guangxin District People′s Hospital, Shangrao City from September 2020 to May 2021 were selected. The patients hospitalized from September 2020 to December 2020 were selected as the control group, and the patients hospitalized from January 2021 to May 2021 were selected as the observation group, with 62 cases in each group. The control group was treated with BiPAP double-level non-invasne ventilator ventilation. The observation group was treated with tiotropium bromide on the basis of the control group. The levels of arterial blood gas indexes, inflammatory factors and pulmonary function indicators were compared between the two groups. Results After 3 days of treatment, the pH value, the arterial partial pressure of oxygen (PaO2) was higher than that before treatment, and the partial pressure of carbon dioxide (PaCO2) was lower than that before treatment, and the pH value and PaO2 of the observation group were higher than those of the control group three days after treatment,and PaCO2 was lower than that of the control group, with statistical significances (P<0.05). After 2 weeks of treatment,tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)were lower than those before treatment, and interleukin-10 (IL-10) was higher than that before treatment, and TNF-α, CRP in observation group were lower than thaose in the control group, and IL-10 was higher than that in the control group, the differences were statistically significant (P<0.05). After 2 weeks of treatment, the first second forced vital capacity (FEV1), forced vital capacity (FVC) and FEV1/FVC of the two groups were higher than those before treatment, and FVC, FEV1 and FEV1/FVC in the observation group were higher than those in the control group, the differences were statistically significant (P <0.05). Conclusion Noninvasive ventilator combined with Tiotropium Bromide can improve arterial blood gas indexes and pulmonary function, reduce inflammatory reaction and improve treatment effect in patients with acute exacerbation of COPD complicated with typeⅡrespiratory failure.
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