Abstract: Objective　To observe the effect of non-invasive positive pressure ventilation (NPPV) combined with lobeline on patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. Methods　A total of 82 patients with COPD and respiratory failure who were admitted to The Seventh Affiliated Hospital of Southern Medical University from January 2020 to October 2021 were selected and were simply randomly divided into two groups with 41 cases in each group. In the control group, there were 25 males and 16 females, with an age of (69.12±7.53) years old; there were 24 males and 17 females in the observation group, with an age of (68.96±7.31) years old. The control group was treated with lobeline, and the observation group was treated with NPPV on the basis of the control group. The blood gas indexes, pulmonary function indexes, and clinical efficacy were compared between the two groups. t test was used for the measurement data, and chi-square test was used for the count data. Results　After 1 week of treatment, the total effective rate of the observation group was 97.56% (40/41), which was significantly higher than that of the control group [80.49% (33/41)], with a statistically significant difference between the two groups (χ²=6.116, P=0.002). After 1 week of treatment, the arterial partial pressure of oxygen (PaO₂) and oxygenation index (PaO₂/FiO₂) in the observation group were (70.35±10.79) mmHg (1 mmHg=0.133 kPa) and (371.14±49.86) mmHg, which were significantly higher than those in the control group [(61.87±10.77) mmHg and (336.07±47.82) mmHg], and the arterial partial pressure of carbon dioxide (PaCO₂) was (49.15±8.27) mmHg, which was significantly lower than that in the control group [(56.03±8.69) mmHg], with statistically significant differences (all P<0.05). After 1 week of treatment, the forced expiratory volume in 1 second (FEV₁), vital capacity (FVC), and peak expiratory flow (PEF) in the observation group were (1.66±0.40) L, (2.63±0.46) L, and (2.87±0.59) L/s, which were significantly higher than those in the control group [(1.37±0.29) L, (2.31±0.40) L, and (2.39±0.54) L/s], with statistically significant differences (all P<0.05). No obvious adverse reactions occurred in the two groups during treatment. Conclusion　NPPV combined with lobeline in the treatment of COPD patients with respiratory failure can significantly improve the clinical efficacy, is safe and reliable, can effectively improve the patients' blood gas and lung function indexes, and greatly promotes their early recovery.

Key words: Chronic obstructive pulmonary disease, Respiratory failure, Non-invasive positive pressure ventilation, Lobeline

摘要： 目的　观察无创正压通气（NPPV）联合洛贝林对慢性阻塞性肺疾病（COPD）合并呼吸衰竭患者的疗效。方法　选择2020年1月至2021年10月期间南方医科大学第七附属医院收治的COPD合并呼吸衰竭患者82例，并简单随机分为两组，各41例。对照组男25例、女16例，年龄（69.12±7.53）岁，给予洛贝林治疗；观察组男24例、女17例，年龄（68.96±7.31）岁，在对照组基础上联合NPPV治疗。比较两组患者血气指标、肺功能指标及临床疗效。计量资料采用t检验，计数资料采用χ²检验。结果　治疗1周后，观察组总有效率为97.56%（40/41），明显高于对照组80.49%（33/41），差异有统计学意义（χ²=6.116，P=0.002）。治疗1周后，观察组动脉血氧分压（PaO₂）、氧合指数（PaO₂/FiO₂）分别为（70.35±10.79）mmHg（1 mmHg=0.133 kPa）、（371.14±49.86）mmHg，均明显高于对照组［（61.87±10.77）mmHg、（336.07±47.82）mmHg］，动脉血二氧化碳分压（PaCO₂）为（49.15±8.27）mmHg，显著低于对照组［（56.03±8.69）mmHg］，差异均有统计学意义（均P<0.05）。治疗1周后，观察组第1秒用力呼气容积（FEV₁）、肺活量（FVC）、最高呼气峰流速（PEF）分别为（1.66±0.40）L、（2.63±0.46）L、（2.87±0.59）L/s，均明显高于对照组［（1.37±0.29）L、（2.31±0.40）L、（2.39±0.54）L/s］，差异均有统计学意义（均P<0.05）。两组治疗过程中未出现明显不良反应。结论　NPPV联合洛贝林治疗COPD合并呼吸衰竭患者能够显著提高临床疗效，安全可靠，有效改善患者血气及肺功能指标，大大促进了患者早日恢复。

关键词: 慢性阻塞性肺疾病, 呼吸衰竭, 无创正压通气, 洛贝林