氨茶碱联合无创正压通气治疗慢性阻塞性肺气肿合并呼吸衰竭疗效评价

目的观察氨茶碱联合无创正压通气（NIPPV）对慢性阻塞性肺气肿合并呼吸衰竭的治疗效果。方法将我院2010～2011年收治的92例慢性阻塞性肺气肿急性加重合并呼吸衰竭的患者分为实验组和对照组，两组均给予化痰、吸氧、抗感染等常规基础治疗，实验组在此基础上加用氨茶碱片并使用面罩进行NIPPV，对两组患者二氧化碳分压（PaCO2）、氧分压（PaO2）及肺动脉压等进行分析比较。结果治疗后实验组患者PaCO2为（44．3±6．7）mmHg．显著低于对照组的（51．2±7．2）mmHg（P〈0．05）；Pa02为（63．7±21．6）mmHg，显著高于对照组的（54．1±19．5）mmHg（P〈0．05）。实验组患者肺动脉压为（43．6±15．3）mmHg，显著低于对照组的（57．2±16．7）mmHg（P〈0．05）。实验组显效25例，有效17例，总有效率为91．3％，对照组显效16例，有效19例，总有效率为76．1％．实验组总有效率显著高于对照组（P〈0．05）。结论氨茶碱联合NIPPV能改善呼吸，提高Pa02，减少二氧化碳潴留，对慢性阻塞性肺气肿合并呼吸衰竭有较好疗效。

Clinical analysis of Aminophylline combined with non-invasive positive pressure ventilation in the treatment of chronic obstructive pulmonary emphysema with respiratory failure

Objective To observe the effect of Aminophylline combined with non-invasive positive pressure ventilation （NIPPV） in treatment of chronic obstructive pulmonary emphysema with respiratory failure. Methods From 2010 to 2011 in our hospital, 92 patients with acute chronic obstructive pulmonary emphysema with respiratory failure were di- vided into experimental group and control group. Both groups were given the treatment with phlegm, oxygen, anti-in- fection. Experimental group used Aminophylline and a mask for NIPPV on the basis of control group. The differences of carbon dioxide partial pressure （PaCO~）, oxygen partial pressure （PaO2） and pulmonary artery pressure between the two groups were analyzed and compared. Results PaCO2 and PaO2 of experimental group after treatment was （44.3±6.7） mm Hg and （63.7±21.6） mm Hg. PaCO2 and PaO2 of control group after treatment was （51.2±7.2） mm Hg and （54.1± 19.5） mm Hg, the difference between them was significant （P 〈 0.05）; pulmonary arterial pressure of experimental group was significantly lower than the control group. The total efficiency of experimental group was significantly higher than that of the control group （P 〈 0.05）. Conclusion Aminophylline combined with NIPPV can improve respiratory function, increase blood oxygen and reduce amount of carbon dioxide retention. It has a good effect on chronic ob- structive pulmonary emphysema with respiratory failure.