BiPAP呼吸机治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭的疗效分析

目的观察BiPAP呼吸机治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭的血气变化情况。方法选取2009年1月～2012年1月我院呼吸内科收治的COPD合并呼吸衰竭患者64例,依据随机化的原则分为治疗组与对照组各32例,对照组予常规对症营养支持治疗。BiPAP治疗组在对照组的基础上予以BiPAP呼吸机通气治疗,观察两组患者治疗前、治疗后2 h、治疗后24 h动脉血气分析,记录PaO2、PaCO2、pH的变化情况。结果与治疗前相比,治疗后2 h及24 h,两组患者的PaO2、PaCO2均有显著改善（P均〈0.05）。且BiPAP治疗组的PaO2较对照组升高更显著,PaCO2较对照组降低更显著,差异具有统计学意义（P〈0.05）。但两组的pH治疗前后未见明显差异。结论应用BiPAP治疗COPD合并呼吸衰竭效果好,能够明显的改善患者的缺氧和二氧化碳潴留症状,操作简单方便,患者易于接受,是一种安全有效值得推广的方法。

Efficacy analysis of BiPAP ventilation in the treatment of chronic obstructive pulmonary disease with acute exacerbation of respiratory failure

Objective To observe the effect and blood gas analysis changes of BiPAP ventilation in the treatment of chronic obstructive pulmonary disease with acute exacerbation of respiratory failure.Methods Respiratory medicine admitted in our hospital from January 2009 to January 2012 in COPD with respiratory failure in 64 patients,according to the random principle were divided into the treatment group and the control group（32 cases）,of the control group were given nutritional support.BiPAP treatment group on the basis of the control group were given the BiPAP ventilator therapy,and arterial blood gas after treatment were observed in patients before treatment,after treatment 2 h,24 h,and recorded PaO2,PaCO2,pH changes.Results Compared with before treatment,after treatment for 2 h and 24 h,the two groups of patients with PaO2,PaCO2 were significantly improved（P0.05）.And the BiPAP therapy group PaO2 compared with the control group increased more significantly,PaCO2 lowered more significantly than that in control group,the difference was statistically significant（P0.05）.However,the two groups had no significant difference in pH before and after treatment.Conclusion BiPAP in treatment of COPD patients with respiratory failure had good,can significantly improve the patient＇s symptoms of hypoxia and carbon dioxide retention,simple,convenient and easily accepted by patients,is a safe and effective method,and it should be promoted.