慢性阻塞性肺疾病合并呼吸衰竭患者无创正压通气治疗作用观察

目的观察无创正压通气（non-invasive positive pressure ventilation,NIPPV）治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）急性加重期合并呼吸衰竭患者的效果。方法COPD急性加重期合并呼吸衰竭住院患者89例随机分为常规治疗组（对照组）和NIPPV治疗组（治疗组）。对照组治疗包括抗感染、支气管扩张剂、祛痰药、糖皮质激素、纠正酸碱平衡以及持续低流量吸氧等;治疗组在常规治疗的基础上,应用无创正压通气的BiPAP呼吸机进行辅助通气。观察2组患者治疗前后呼吸频率（RR）、心率（HR）、酸碱度（pH）、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）以及生命体征的变化等。结果经治疗后,治疗组的上述各项指标与治疗前相比均有明显改善（P〈0.05）,患者插管率、住院天数、病死率均显著低于对照组（P〈0.05）;对照组在治疗后,除PaCO2有明显下降（P〈0.05）外,其他各项指标与治疗前比较虽有所改善,但无统计学意义。结论NIPPV对COPD合并呼吸衰竭患者的疗效确切,有利于呼吸衰竭的纠正,是抢救COPD合并呼吸衰竭患者的有效疗法。

Clinical observation of non-invasive positive pressure ventilation for treatment of chronic obstructive pulmonary disease complicated respiratory failure

Objective To observe and evaluate the effect of non - invasive positive pressure ventilation （NIPPV） on chronic obstructive pulmonary disease （COPD） patients with respiratory failure. Methods The respiratory rate （RR） , heart rate （HR）, arterial blood gas index （PaO2, PaC02, pH） , numbers of endotracheal intubation, mortality and hospitalized clays of NIPPV group were observed, and these index was compared with control group （ COPD patients without NIPPV treatment ）. Results The above - mentioned index were improved significantly in NIPPV group after treatment, and hospitalized days was significantly shorter, numbers of endotracheal intubation, and mortality were obviously lower in NIPPV group than those in control group （ P 〈 0.05 ）. Conclusion These results suggest that the NIPPV is an effective therapeutic method in the treatment of COPD patients with respiratory failure.