COPD患者呼吸衰竭时的无创正压通气序贯治疗时机研究

目的 研究无创正压通气序贯治疗AECOPD患者呼吸衰竭的治疗时机.方法 入住ICU的患者中,选取需行无创正压通气序贯治疗的AECOPD呼吸衰竭患者,根据自主呼吸试验时间分为30分钟组、2小时组和24小时组,观察每组患者在无创正压通气序贯治疗后48小时内的再插管率.结果 符合条件的102例患者随机分为三组,每组34例,30分钟组的再插管率为81.2%,2小时的再插管率为17.6%,24小时的再插管率为14.7%,30分钟组与2小时组、24小时组相比的差异有显著统计学意义（P〈0.05）,而2小时组和24小时组的再插管率差异无统计学意义（P〉0.05）.结论 当自主呼吸试验时间超过2小时,采用无创正压通气序贯治疗AECOPD患者呼吸衰竭时再插管率低,有较高的治疗成功率.

Research on treatment chance of SNPPV for COPD patients with respiratory failure

Objective To study the sequential ventilation treatment chance for AECOPD patients with respiratory failure by non- invasive positive pressure ventilation （NPPV）. Methods AECOPD patients with respiratory failure in ICU from September, 2010 to Sep- tember, 2012 were selected to give sequential non-invasive positive pressure ventilation （SNPPV） treatment. Based on self spontaneous test time （SFFF） , these patients were divided into the 30 minutes group, the 2 hours group and the 24 hours group. The re-intubated rate after SNPPV treatment was observed among the 3 groups. Results 102 qualified patients were randomly divided into three groups, 34 ca- ses each. The re-intubated rate was 81.2% in the 30 minutes group, 17.6% in the 2 hours group, and 14.7% in the 24 hours group re- spectively. There was no significant difference between the latter two groups （ P 〉 0. 05 ）. Condusion For AECOPD patients complicated with respiratory failure treated by SNPPV, there is a lower re-intubated rate and higher successful rate when the duration of SPTT is more than 2 hours.