双水平气道正压通气治疗慢性阻塞性肺疾病急性加重期伴Ⅱ型呼吸衰竭的临床研究

目的探讨经口鼻/鼻面罩双水平气道正压通气（BiPAP）治疗慢性阻塞性肺疾病急性加重期（AECOPD）伴Ⅱ型呼吸衰竭的价值。方法将80例AECOPD并Ⅱ型呼吸衰竭患者随机分为2组,常规治疗组（对照组）40例,常规治疗加BiPAP治疗组（观察组）40例。对2组患者的临床症状、辅助检查、血气分析、疗效进行分析。结果观察组治疗有效率（85.0%）高于对照组（62.5%）（P〈0.05）。治疗后2组的PaO2、PaCO2和pH值较治疗前均有改善（P〈0.05）,且观察组改善较对照组明显（P〈0.05）,平均住院时间及病情好转时间均较对照组缩短（P〈0.05）。结论应用BiPAP治疗AECOPD并Ⅱ型呼吸衰竭疗效显著。

Clinical observation of Bi-level positive airway pressure treatment acute exacerbations of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

Objective To evaluate the therapeutic effect of Bi-level positive airway pressure（BiPAP） ventilation via oronasal/nasal mask in patients with acute exacerbations of chronic obstructive pulmonary disease（AECOPD） complicated with typeⅡrespiratory failure.Methods Eighty patients with AECOPD complicated with typeⅡrespiratory failure were divided into two groups,40 patients were administrated to conventional therapy（control group） and 40 patients were applied to conventional therapy with BiPAP（experimental group）.The symptoms,physical inspection and the result of blood gas and clinic manifestation in each group were comparatively analyzed.Results The total effective ratio was 85.0%in experimental group,and higher than that in control group（62.5%,P0.05）.There were improvement in PaO_2,PaC_2,pH and clinic manifestation in both control group and experimental group after treatment（P0.05）,and it was more obviously in experimental group（P0.05）.The average duration of hospitalization were decreased in experimental group（P0.05）.Conclusion It demonstrated that the BiPAP was an effective ventilation pattern for patients with acute exacerbations of chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure.