无创呼吸机治疗慢性阻塞性肺疾病急性加重期呼吸衰竭临床分析

目的探讨双水平气道无创正压通气（BiPAP）呼吸机治疗慢性阻塞性肺疾病急性加重期（AECOPD）合并Ⅱ型呼吸衰竭的临床疗效。方法对2010年1月-2012年12月收治的80例AECOPD合并Ⅱ型呼吸衰竭患者的临床资料行回顾性分析,根据实施BiPAP呼吸机辅助通气治疗与否分为呼吸机研究组与对照组,每组各40例,比较生命体征及血气分析变化、疗效及医疗费用。结果研究组治疗前后,生命体征及血气分析各项指标比较显示出逐渐好转的一致性趋势（P〈0.05）;治疗3 d后,研究组患者生命体征及血气分析各项指标改善明显优于对照组（P〈0.05）。较之对照组,研究组治疗总有效率增高,住院时间缩短,插管例数明减少,医疗费用减少（P〈0.05）。结论 BiPAP无创呼吸机在改善AECOPD呼吸衰竭患者的生命体征、血气分析指标、气管插管率、住院时间等方面效果显著,值得推广。

Clinical Analysis on Noninvasive Ventilator in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Respiratory Failure

Objective To observe the clinical curative effect of bilevel positive airway pressure（BiPAP） noninvasive ventilator in the treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） with respiratory failure. Methods The clinical materials of 80 patients with AECOPD with respiratory failure were reviewed and analyzed from January 2010 to December 2012. The patients were divided into two groups based on whether BiPAP mechanical ventilation therapy was implemented or not. The vital signs and arterial blood gas analysis, curative effect and medical expenses were compared between the two groups. Results The indexes of vital signs and blood gas analysis before and after treatment showed the consistency of the trend of gradual improvement（P 〈0.05）. After 3-day treatment, the indexes of vital signs and blood gas analysis in the study group were signifi cantly better than the control group（P 〈0.05）. Compared with the control group, the total effective rate was signifi cantly higher, the hospital stay was signifi cantly shorter, the intubation was signifi cantly less, and the medical expenses were signifi cantly lower in the study group（P〈 0.05）. Conclusion The BiPAP non-invasive ventilator has signifi cant effect in improving vital sign, index of blood gas analysis, rate of endotracheal intubation and length of stay, which is worthy of further promotion.