COPD急性呼吸衰竭无创机械通气疗效观察

目的　探讨无创面罩机械通气 (NPPV)治疗慢性阻塞性肺疾病 (COPD)急性呼吸衰竭 (ARF)的疗效。方法　符合COPD患者分为三组 :A组 12例 ,Pa CO2 <5 5 mm Hg且 6 0 mm Hg>Pa CO2 >4 5 mm Hg;B组 :11例 Pa O2 <5 5 mm Hg且 Pa O2 >6 0mm Hg;C组 :18例 ,Pa O2 <5 5 mm Hg且 Pa O2 >4 5 mm Hg,拒绝 NPPV治疗。A、B组予无创面罩通气 ,Sport模式下联合应用压力支持 (PSV)通气 ,及持续气流治疗。治疗前后监测血气分析及临床症状变化。结果　NPPV通气组 1h后血气指标及一般情况明显改善 ,2 4 h继续明显改善 ,非 NPPV组 1h上述指标无改善 ,2 4 h时比治疗前有改善 ,但改善较 NPPV组有显著差异。结论　无创面罩通气是有效治疗 COPD并 ARF的一线治疗方法

The effect of noninvasive mask ventilation in treatment of COPD with acute respiratory faith

Objective To investigate the potential advantage of noninvasive mask ventilation in treatment of COPD with acute respiratory failure.Methods The patients were divided to three groups, group A:12 patients with PaO 2 < 55 mmHg and 60 mmHg >PaO 2> 45 mmHg; group B:11 patients with PaO 2< 55mmHg and PaO 2< 55 mmHg; group C:18 patients who refused mechanical ventilation with PaO 2 <55mmHg, PaO 2> 45mmHg, we used the method of noninvasive mask ventilation combined pressure support ventilation, positive end-expiratory pressure and Bias flow to treat patients of group A, B.Results The value of blood gas analysis and clinical signs of group A, B was significantly improved after 1 hour late of NPPV and continually improved did not improve within 24 hours. The parameters above did not improve with group C, but after 24 hours treatment, the parameters of blood gas analysis and clinical signs improve significantly. But there was significant difference with that of group A, B.Conclusion Noninvasive mask ventilation is the first line of effective treatment of COPD with acute respiratory failure.