BiPAP治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效观察

目的 观察BiPAP治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效.方法 将60例慢性阻塞性肺疾病合并呼吸衰竭患者分为治疗组和对照组各30例,对照组予以对症支持治疗；治疗组在对照组的基础上联合Bi-PAP呼吸机进行治疗,比较两组患者治疗前后心率、呼吸频率的变化情况及比较两组患者治疗前后血气分析结果.结果 治疗组治疗后的心率、呼吸频率均明显降低,且治疗组较对照组降低更显著.治疗组和对照组治疗后的pH、PaO2、PaCO2、SaO2均较治疗前显著改善,差异有统计学意义(P＜0.01)；且治疗组治疗后上述指标分别与对照组比较,差异有统计学意义(P＜ 0.05或P＜ 0.01).结论 BiPAP治疗慢性阻塞性肺疾病合并呼吸衰竭疗效确切,但应严格掌握适应证,对严重呼吸衰竭、排痰困难或意识不清醒不能配合无创呼吸机治疗的,以及经无创通气治疗2～4 h通气功能无明显改善者,应尽早进行有创通气治疗,以免延误抢救时机.

Clinical observation of BiPAP in treatment of chronic obstructive pul- monary disease with respiratory failure

Objective To observe the clinical efficacy of BiPAP treatment of chronic obstructive pulmonary disease with respiratory failure. Methods All 60 patients with chronic obstructive pulmonary disease and respiratory failure patients were divided into treatment group and control group of 30 cases, 30 patients in the control group were symp- tomatic and supportive treatment, treatment group of 30 patients on the basis of joint treatment were combined with BiPAP ventilator. The two groups were compared before and after the changes in heart rate, respiratory rate and blood gas analysis results. Results After treatment, heart rate, respiratory rate were significantly lower in the treatment group compared with the control group decreased more significantly. Treatment group and the control group after treatment pH, PaO2, PaCO2,SaO2 than before treatment significantly improved, the difference was significant resistance （P 〈 0.01 ） and the treatment group after treatment,the indicators, respectively, with the control group comparison, the difference was significant（P 〈0.05 or P 〈0.01 ）. Conclusion BiPAP treatment of chronic obstructive pulmonary disease with respiratory failure has exact efficacy. But it should be strictly controlled indications, severe respiratory failure, difficult expectoration or sober awareness can not cope with non-invasive ventilation in the treatment,and no signifi- cant improvement by non-invasive ventilation 2-4 h ventilatory function should be carried out as soon as possible in- vasive ventilation, so as not to delay the rescue time.