Comparative Study for Clinical Effect in Treating COPD Patients Complicated with Pulmonary Heart Disease and TypeII Respiratory Failure between Invasive and Non- invasive Sequential Mechanical Ventilation and Simplex Invasive Mechanical Ventilation

Objective To compare the clinical effect in treating COPD patients complicated with pulmonary heart disease and type Ⅱ respiratory failure between invasive and non- invasive sequential mechanical ventilation and simplex invasive mechanical ventilation. Methods A total of 132 COPD patients complicated with pulmonary heart disease and type Ⅱrespiratory failure were selected in Yangpu Hospital Affiliated to Tongji University from March 2013 to March 2015,and they were randomly divided into A group and B group, each of 66 cases. Patients of both groups received endotracheal intubation and mechanical ventilation,patients of A group received non- invasive mechanical ventilation after getting non- invasive ventilation indications, while patients of B still received invasive mechanical ventilation after getting non- invasive ventilation indications. Blood- gas index( including Pa O2,Pa CO2 and p H),SBP and HR before treatment and after 72 hours of treatment,pulmonary function index( including FVC and FEV1) before treatment and after 1 week of treatment,incidence of VAP,fatality rate,total mechanical ventilation time and hospital stays were compared between the two groups. Results No statistically significant differences of Pa O2,Pa CO2,p H,SBP or HR was found between the two groups before treatment or after 72 hours of treatment( P 0. 05); Pa O2,p H and SBP of the two groups after 72 hours of treatment were statistically significantly higher than those before treatment,while Pa CO2 and HR of the two groups after 72 hours of treatment were statistically significantly lower than those before treatment( P 0. 05). No statistically significant differences of FVC or FEV1 was found between the two groups before treatment or after 1 week of treatment( P 0. 05); while FVC and FEV1 of the two groups after 1 week of treatment were statistically significantly higher than those before treatment( P 0. 05). No statistically significant differences of incidence of VAP was found between the two groups( P 0. 05); total mechanical ventilation time and hospital stays of A group were statistically significantly shorter than those of B group( P 0. 05). Conclusion Invasive and non- invasive sequential mechanical ventilation has similar clinical effect in treating COPD patients complicated with pulmonary heart disease and type Ⅱrespiratory failure with simplex invasive mechanical ventilation,but invasive and non- invasive sequential mechanical ventilation can more effectively reduce the incidence of VAP and shorten the total mechanical ventilation time and hospital stays.