无创正压通气治疗慢性阻塞性肺疾病急性加重期疗效观察

目的探讨两种无创通气方式治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的临床效果。方法 60例慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者,按无创通气方式不同随机分为甲、乙2组,每组30例。2组均采用常规治疗(抗感染、解痉、平喘、祛痰及氧疗),在此基础上,甲组采用持续双水平气道正压通气治疗,乙组采用间断双水平气道正压通气治疗。观察2组患者治疗前、治疗24及48 h后的动脉血气(pH值、p(CO2)、p(O2))。结果甲组治疗24 h及48 h pH值、p(CO2)、p(O2)较乙组显著改善(P均<0.05)。结论持续双水平气道正压通气是治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的有效方法。

Observation of effect of noninvasive positive pressure ventilation in treatment of acute exacerbations of chronic obstructive pulmonary diseases

Objective It is to approach the clinical effect of the two noninvasive positive pressure ventilation(NIPPV) methods in treatment of acute exacerbations of chronic obstructive pulmonary diseases(AECOPD) combined with type II respiratory failure.Methods Six patients with AECOPD combined with type II respiratory failure were randomly divided into group A and B according to different noninvasive ventilation ways,30 cases in each group.Both groups were given conventional therapy(anti-infective,antispasmodic,antiasthma,expelling phlegm and oxygen therapy),on this basis therapy,the patients were treated with continuous bi-level positive airway pressure(BIPAP) treatment in group A and intermittent BIPAP in group B.The arterial blood gases(pH value,p(CO2),p(O2)) of the two groups were observed before and after treatment.Results After treated for 24-and 48-hour,the pH value and p(CO2),p(O2) of group A were more significantly improved than group B(P<0.05).Conclusion The continuously BIPAP is an effective method for AECOPD with type II respiratory failure.