Treatment Effect Of The BiPAP Noninvasive Ventilator For Patients With Severe COPD Accompanied Chronic Respiratory Failure

The background Severe COPD patients usually accompany with chronic respiratory failure. The treatment outside the hospital is difficult and key points in the process of treatment. Home oxygen therapy was once thought to be the most safe and effective, simple and economic treatment, has been in use today. But home oxygen therapy has certain limitations, especially for severe and merge hypercapnia sex respiratory failure of COPD patients. Not effectively reduce carbon dioxide levels, and it’s easy to increase carbon dioxide retention in night, Also cannot reduce airway obstruction. Noninvasive ventilator is widely used in clinical work. There have been many studies have shown that in chronic respiratory failure, noninvasive ventilator can play a better role, has important application value in clinical.ObjectiveThe Objective of this test is to research the days of BiPAP noninvasive ventilator for the treatment of severe COPD patients with chronic respiratory failure, and to provide basis for the household noninvasive ventilator therapy through analyzing of these indicators of patients with acute exacerbation aggravating readmission rate and mortality, lung function(FEV1 and FVC %, IC), blood gas analysis(p H PO2 PCO2), 6 minutes walk test(6MWT) distance.Methods The AECOPD patients came to our hospital for treatment from October 2012 to October 2014 were selected.we given oxygen cure, spasmolysis, phlegm, and asthma, anti-infection and invasive or noninvasive ventilator therapy intensification immediately after admission. After treatment for acute stage, Cough, sputum, fever, breathing difficulties and other symptoms improved, Arterial blood gas prompted, there is still Type II respiratory failure criteria. Lung function shows that severe obstructive airway disorders. These patients feed into the research. A total of 50 cases.Each patient check the pulmonary function, blood gas analysis, 6 minute walk test before left hospital. 25 cases assigned into experimental group. All of them accepted noninvasive ventilator application training and health education, bought noninvasive ventilator for family use, of which 18 men, 7 women, age 64.25 + /-12.98 years, until the end of the experiment, a total of 23 people(experimental group two people in the hospital within 1 year automatically stop wearing breathing machine, exit test). 25 patients assigned into control group, home oxygen therapy, including 19 men and 6 women, age 66.12 + /- 66.12.All of patients’ BMI, p H, PO2, PCO2, 6WMT, FEV1%and FVC, IC were no statistical difference before Discharging. All the patients reviewed after 1 month, 3 months, 6 months and 1 year, then to carry on statistical analysis.With a follow-up of 1 year and patients death as the end point. IF patients from experimental group stopped wearing during the study, quit the t test.Results The analysis blood gas, 6 minutes walking distance experiment, lung function are no difference in two groups. Two people in the experimental group stop wearing the machine within 1 year are excluded to the test. There are six people in this group readmission within 1 year after discharge, A total of 69 days,there were no death patients, there were eight people in control group readmission, within one year,A total of 160 days,and there was one person dead after half a year. Arterial blood gas: After 1 month, 3 months, 6 months, 1 year after the experiment in the way, have improved significantly.In1, 3, 6 months and 1 year after compared with before discharge, no obvious difference, in control group.1 years later, the comparison between groups, the difference was statistically significant. Lung function: FEV1 and FVC % had no obvious change in 1 years later, IC elevated 1 years later, difference was statistically significant.There was no statistically significant difference compared with before discharge, in control group.6MWT:there was averaged 2.5 + /- 0.6m a year later in experimental group, and difference was statistically significant. A year later there was no statistically significant difference compared with before discharge, in control group. The correlation analysis suggests that it’s positively correlated in the 6MWT and IC.Conclusion BiPAP can improve chronic respiratory failure in low oxygen concentration and hypercapnia, And it can reduce a patient’s risk of readmission, prolong the survival time without incident, reducing the speed of lung function decline, increased activity in patients with endurance, and improve the quality of life.