慢性阻塞性肺病合并呼吸衰竭患者院前无创通气的探讨OA

Objective:This study aims to systematically evaluate the improvement effect of non-invasive positive pressure ventilation(NIPPV)in the pre-hospital first aid stage on the blood gas analysis index,vital signs and clinical prognosis of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure,and to explore its application value and promotion in emergency medicine.Broad strategy.Method:Using the retrospective analysis method,102 patients with COPD combined with respiratory failure admitted to Nanjing Emergency Center from January to June 2023 were selected as research subjects.According to the respiratory support strategy adopted during pre-hospital first aid,the patients were divided into observation group and control group,with 51 cases in each group.The control group only received conventional mask oxygen absorption treatment due to the equipment configuration restrictions of emergency vehicles or differences in disease assessment,the observation group immediately implemented non-invasive positive pressure ventilation support on the way to transport on the basis of conventional treatment.Compare and analyze the changes of arterial blood gas analysis indicators(PaO2,PaCO2,pH value),physiological monitoring indicators(SpO2,respiratory frequency RR,heart rate HR)and oxygenation index(OI)at the first aid site(before intervention)and admission(after intervention)of the two groups.The total effective rate of clinical treatment was calculated.Result:After the intervention,the improvement of the blood gas index in the observation group was significantly better than that of the control group,with a statistically significant difference(P＜0.05).In terms of physiological indicators,the SpO2 of the observation group was significantly higher than that of the control group,while the respiratory rate and heart rate were significantly lower than those of the control group,with statistically significant difference(P＜0.05).In addition,the increase in oxygenation index of the observation group was significantly better than that of the control group,with a statistically significant difference(P＜0.05).In the clinical efficacy evaluation,the total efficiency of the observation group was higher than that of control group.The difference of the two groups was statistically significant(P＜0.05).Conclusion:During the"golden time"of pre-hospital first aid,non-invasive positive pressure ventilation for patients with COPD combined with respiratory failure can quickly correct hypoxemia and hypercarbonemia,optimize the ventilation/blood flow ratio,and reduce respiratory muscle fatigue,thus effectively curb the deterioration of the disease.This technology not only significantly improves the success rate of pre-hospital first aid,but also lays a good physiological foundation for the further treatment of patients after admission,which has high clinical application value and promotion significance.