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

Abstract

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 Ⅱ respiratory failure.Methods Eighty elderly patients with moderate to severe COPD and type Ⅱ respiratory failure were selected and randomly divided into observation group (n =40) and control group(n =40).The two groups were given conventional anti infection,oxygen inhalation,spasmolysis,expectorantand other conventional 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 were received 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)％ ;control group:(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),and 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 Ⅱ respiratory failure. Key words: Bi-level positive airway pressure; Seretide; Chronic obstructive pulmonary disease; Respiratory failure; Quality of life