无创机械通气在慢性阻塞性肺病合并Ⅱ型呼吸衰竭治疗中的应用

目的探讨无创呼吸机对慢性阻塞性肺疾病（COPD）合并Ⅱ型呼吸衰竭的临床疗效。方法96例符合诊断标准的患者，在常规予以氧疗、通畅气道、抗感染、纠正酸碱失衡及呼吸兴奋剂等内科治疗的基础上，其中54例同时应用BiPAP呼吸机进行经口鼻面罩正压无创通气治疗（治疗组），治疗持续7～14天。42例未行无创通气患者为对照组。观察通气前、后血PH值、PaCO2、PaO2、呼吸频率（RR）、心率（HR）及意识的变化情况。结果治疗组治疗后pH值纠正，PaO2明显升高，PaC02明显降低，心率和呼吸频率也相应的减慢，意识好转，与治疗前相比差异有统计学意义（P〈0．05）。与对照组相比，各指标改善幅度及平均住院时间差异有统计学意义（P〈0．05）。结论无创通气治疗COPD合并Ⅱ型呼吸衰竭疗效肯定，可明显提高PaO2，并使PaCO2下降，有效改善患者的意识，减少住院时间。

Noninvasive positive pressure ventilation for typeⅡrespiratory failure in chronic obstructive pulmonary disease

Objective To explore the efficacy of non-invasive positive pressure ventilation for COPD complicated with type Ⅱ respiratory failure. Methods 96 patients with COPD complicated with type Ⅱ respiratory failure were assigned to BiPAP plus conventional therapy （treatment group） or conventional therapy alone （control group）. 42 patients were divided into control group treated with conventional therapy, including oxygen therapy, airway control, antibiotics, correcting acid-base imbalance and respiratory stimulant. 54 patients were divided into treatment group treated with noninvasive BiPAP with oral-nasal mask in addition to conventional therapy. Noninvasive BiPAP were lasted 7--14 days in treatment group. The PH, PaCOz, PaOz, respiratory rate（RR） , heart rate HR） and consciousness before and after pressure ventilation were observed. Results The PH, PaCO2 and PaO2 were significantly improved after non-invasive positive pressure ventilation （P〈0.05）. There were significantly difference in ventilatory parameters and average stay between treatment group and control group （P〈0. 05）. Conclusion Non-invasive positive pressure ventilation for COPD complicated with type Ⅱrespiratory failure is effective.