无创正压通气治疗慢性阻塞性肺疾病合并严重呼吸衰竭48例临床分析

目的:探讨无创正压通气对慢性阻塞性肺疾病(COPD)并发严重呼吸衰竭的治疗效果。方法:48例患者除给予常规治疗外,使用呼吸机给予无创正压通气,选用压力支持通气模式(PSV),自主呼吸减弱时则改为SIMV+PSV模式。结果:40例患者完成治疗,8例改用有创通气治疗。40例治疗成功病例的通气时间平均为(8.5±5.3)d,其动脉血气分析、呼吸、心率均较通气前明显改善(P<0.05),治疗成功与失败者在重症肺部感染、痰多、APACⅡ评分方面差异有统计学意义(P<0.05)。结论:经面罩无创通气治疗COPD并发严重呼吸衰竭效果较好,有一定应用价值,但应掌握适应证,合理应用。

Noninvasive positive pressure ventilation in chronic obstructive pulmonary disease complicated with severe respiratory failure

Objective： To evaluate the efficacy of noninvasive positive pressure ventilation in chronic obstructive pulmonary disease complicated with severe respiratory failure. Methods： Forty eight patients were treated with conventional treatment plus noninvasive positive pressure ventilation,the mode of ventilation was PSV, or SIMV＋PSV with the presence of weakened spontaneous breath. Results： With anav erage treating time of （8.5±5.3） days, the treatment was successful in forty patients, outcomes of arterial blood gas analysis, breath, and heart beat rates were greatly improved; the patients were discharged well （P〈0.05） ; while invasive ventilation was supplemented to other 8 patients. Significant differences in the lung infection, profuse sputum and APAC Ⅱ scores were presented between the forty successful cases and the 8 failed ones. Conclusions： Noninvasive mechanical ventilation shows good effects on COPD complicated with severe respiratory failure, and the key to successful treatment is presence of proper indications.