无创正压通气治疗COPD急性加重期合并Ⅱ型呼吸衰竭的临床观察

目的：观察NIPPV在治疗COPD急性加重期合并Ⅱ型呼吸衰竭患者中的临床疗效。方法：治疗组49例COPD急性加重期合并Ⅱ型呼吸衰竭患者在常规抗感染、平喘、祛痰的基础上进行NIPPV治疗，另外同样呼衰的40例作为对照组仅给予常规治疗（抗感染、平喘、祛痰和呼吸兴奋剂，持续低流量吸氧），观察NIPPV治疗的临床疗效。结果：两组患者治疗前的基础情况无显著性差异（P〉0．05）。治疗组和对照组在治疗结束时pH、PaCO2、PaO2、心率和呼吸频率与治疗前比较均有明显改善，差异有显著性（P〈0．05）。治疗组在降低PaCO2、呼吸频率和提高PaO2方面比对照组效果更明显，有显著性差异（P〈0.01）。治疗组抗生素使用时间和住院时间、住院费用与对照组相比明显减少，差异有显著性（P〈0．05）。结论：COPD急性加重期合并Ⅱ型呼吸衰竭的患者，NIPPV治疗能更有效地降低PaCO2、呼吸频率，提高PaO2，缩短抗生素使用时间和住院时间，节约医疗费用。

Application of NIPPV in treatment of COPD at acute exacerbation phase combined with type Ⅱ respiratory failure

Objective： To observe the clinical effect of NIPPV in treatment of COPD at acute exacerbation phase combined with type Ⅱ respiratory failure. Methods： 49 cases of therapeutic group treated with conventional therapy such as antibiotic, pacifying gasp, eliminating phlegm,respiratory stimulant, continual low-flowoxygen as well as NIPPV. Whereas 40 cases control group treated with conventional intervention only. Results： There was no significant difference statistically between the two groups：（P〉0.05）. Indicators of pH, PaCO2, PaO2, HR and RR of the two groups were significantly different （P〈0.05） before and after treatment. The therapeutic group showed significantly more positive effect of lowering PaCO2, RR and im- proving PaO2 than that of the control group （P〈0.05）. The therapeutic group had less antibiotic consumption, shorter hospital-stay time,and lower fee than that of the control group （P〈0.05）. Conclusion： NIPPV intervention can effectively lower PaCO2, RR and improve PaO2, shorten the course of medication and in-hospital-stay,and reduce medical expenses.