无创正压通气治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的疗效观察

目的探讨无创正压通气（NIPPV）在慢性阻塞性肺疾病急性加重期（AECOPD）并Ⅱ型呼吸衰竭中的应用价值。方法86例AECOPD合并Ⅱ型呼吸衰竭患者完全随机分为治疗组（52例）和对照组（34例），治疗组在接受常规治疗的同时给予NIPPV治疗。比较2组动脉血气、呼吸频率、心率改变、插管率及病死率。结果治疗组治疗后动脉血气和呼吸频率、心率改善显著，与对照组比较差异有统计学意义（P〈0．05），治疗组52例患者中8例气管插管行机械通气，4例因家属拒绝气管插管死亡；对照组中34例患者中12例气管插管机械通气，7例因家属拒绝气管插管死亡，差异有统计学意义（P〈0．05）。结论使用无创正压通气可显著改善COPD合并Ⅱ型呼吸衰竭患者的动脉血气和生命体征，减少插管率及病死率，是治疗此类患者有效的方法。

Clinical study of noninvasive positive pressure ventilation for treating chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

Objective To investigate the efficacy of noninvasive positive pressure ventilation (NIPPV) for treating acute exacerbations of chronic obstructive pulmonary disease (AECOPD) with Type Ⅱ respiratory failure. Methods Eighty-six cases of AECOPD with Type Ⅱ respiratory failure were randomly assigned into a treatment group (52 cases) and a control group (34 cases). The control group was treated with standard therapy, and the treatment group was given standard therapy and immediate NIPPV mode. Comparison was made between the two groups for arterial blood gas, respiratory rate, heart rate, intubation rate and death rate. Results The treatment group showed improvement in blood gas analysis, respiratory rate, and heart rate comparing with the control group (P<0.05), and intubation rate and death rate were lower in the treatment group than in the control group (P< 0.05). Conclusion NIPPV improves the vital signs and arterial blood gas of AECOPD with Type Ⅱ respiratory failure, and reduces the intubation rate and death rate; and it is an effective method.