无创正压通气治疗慢性阻塞性肺疾病急性加重并呼吸衰竭的临床应用研究

目的评价无创正压通气(NPPV)治疗慢性阻塞性肺疾病急性加重期(AECOPD)并呼吸衰竭的临床疗效,并对其使用方法进行分析。方法将57例AECOPD并呼吸衰竭患者随机分为两组,治疗组29例,在常规治疗的基础上予以NPPV治疗;对照组28例仅予以常规治疗。观察指标包括动脉血气分析、呼吸频率、心率、住院天数及气管插管率。结果治疗组患者动脉血酸碱度(pH)、氧分压(PaO2)、二氧化碳分压(PaCO2)、呼吸频率、心率比对照组明显改善(P<0.05)。治疗组与对照组平均住院天数分别为11±6天、19±7天(P<0.05),气管插管率分别为6.90%、32.14%(χ2=13.8,P<0.01),病死率分别为3.44%、10.71%(χ2=5.23,P<0.05)。结论 NPPV治疗COPD呼吸衰竭疗效确切,可降低患者病死率、气管插管率及住院天数。

Clinical Study on Noninvasive positive Pressure Ventilation for Patients with Acute Exacerbations Chronic Obstructive Pulmonary Diseases with Respiratory Failure

Objective To assess the efficacy of noninvasive positive pressure ventilation(NPPV) for acute exacerbations of chronic obstructive pulmonary disease(AECOPD) patients,and the method of use for analysis.Methods A total of 57 patients suffering from respiratory failure due to exacerbation of COPD were randomly divided into two groups:treatment group(29 cases),with the routine treatment on the basis of NPPV treatment,and control group(28 cases) with only routine treatment.Arterial blood gases,respiratory rate,heart rate,be in hospital days,incubation rate were observed.Results In the treatment group,arterial blood acid-base value(pH),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),respiratory rate and heart rate were improved significantly after treatment compared with the control group(P<0.05).Compared with the controlled group,the duration of hospitalization was significantly shorter(11±6 days vs 19±7days,P<0.05),the incubation rate was significantly lower(6.90% vs 32.14%,χ2=13.8,P<0.01)and the fatality rate was significantly lower(3.44% vs 10.71%,χ2=5.23,P<0.05)in the treatment group.Conclusion It is clinical sure that NPPV ventilator had good efficacng to treat COPD with respiratory failure.The fatality rate,the incubation rate and the duration of hospitalization is decreased.