BiPAP呼吸机治疗呼吸衰竭的价值及其局限性

目的：探讨双水平气道正压无创机械通气治疗呼吸衰竭的临床效果。方法：对47例呼吸衰竭使用无创BiPAP呼吸机治疗的病例进行回顾性分析。结果：BiPAP呼吸机对提高血氧饱和度的效果肯定，对CO2潴留患者上机1d后PaCO2有所下降，但与上机前相比差异不显著，上机3d后可见PaCO2有显著下降（P＜0．05）。3例COPD重症Ⅱ型呼衰通过有创－无创序贯治疗取得成功。配合纤支镜吸痰并适量呼吸兴奋剂有助于提高疗效，良好的管理培训和而耐心细致的操作监护也是至关重要的。结论：BiPAP机无创通气治疗呼吸衰竭疗效肯定，减少了有创机械通气的使用，但其不能完全替代有创通气，且须配合其他有关治疗才能取得较好效果。

The Value and Limitation of Noninvasive Pressure Support Ventilation in Pa-tients with Respiratory Failure

Objective: To investigate the clinical effect of noninvasive bilevel positive airway pressure(BiPAP) support ventilation in patients with respiratory failure. Methods:47 cases of respiratory failure were retrospectively analysed. Results: The SaO2 value improved in all cases and PaCOi value in CO2 retention patients decreased significantly three days after venlilation(P <0.05). Three acute respiratory failure due to chronic obstrutive pulmonary disease were treated succesfully via invasive-noninvasive sequential ventilation. Sputum aspiration via fibrobronchoscope and proper respiratory stimulating agents improved the effect. Careful operation and surveillance were important. Conclusion: Noninvasive biPAP ventilation has clinical efficiency on respiratory failiure,especially cooperated with other treatment,but can not substituted the invasive ventilation.