慢性阻塞性肺疾病并发急性呼吸衰竭的临床对策

目的 观察慢性阻塞性肺疾病（COPD）合并Ⅱ型呼吸衰竭患者应用BiPAP呼吸机正压通气治疗的效果。方法 45例COPD急性发作并Ⅱ型呼吸衰竭者随机分为两组，治疗组23例采用BiPAP＋常规治疗，对照组22例仅采用常规治疗，比较治疗前、治疗2、24h后两组同期动脉血气及呼吸频率、心率改变。结果 治疗组PaO2、PaCO2、pH值较治疗前明显改善（P〈0．05），与对照组比较差异有统计学意义（P〈0．05）；呼吸频率、心率改变也较对照组明显（P〈0．05）。气管插管发生率及平均住院天数均少于对照组（P〈0．05）。结论 BiPAP是治疗慢性阻塞性肺疾病急性发作期并Ⅱ型呼吸衰竭经济、有效的方法。

Treatment of respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary diseases through bilevel positive airway pressure ventilation via nasal/mouth mask

Objective To evaluate the clinical effectiveness by using bilevel positive airway pressure(BiPAP) ventilation via nasal/mouth mask in patients with respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary diseases(COPD).Methods 23 patients were randomly divided into standard therapy plus BiPAP and 22 patients to standard therapy.Cliniacl manifestation(including respiratoryrate,heart rate,blood pressure and conscious status)and arterial blood gas analysis before and after 2 h,24 h after treatment in each group were comparatively analyzed.Results After treatment by BiPAP,patients showed a significant improvement in PaO2,PaCO2,and clinical manifestation.And there was a significant difference between two groups(P<0.05).Conclusion BiPAP ventilation is effective in patients with respiratory failure during acute exacerbation of COPD.