无创正压通气治疗 AECOPD 并呼吸衰竭的临床应用研究

目的：评价无创正压通气（NIPPV）治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效。方法将66例 AECOPD 并呼吸衰竭患者分为2组，试验组33例，在常规治疗的基础上予以 NIPPV 治疗；对照组33例仅予以常规治疗。观察指标包括呼吸频率（RR）、心率（HR）、血氧饱和度（SaO2），动脉血 pH 值（pH）、氧分压（PaO2）、二氧化碳分压（PaCO2）。结果治疗后试验组患者的呼吸频率（RR）、心率（HR）、血氧饱和度（SaO2）、动脉血 pH 值（pH）、氧分压（PaO2）、二氧化碳分压（PaCO2）比对照组明显改善（P<0.05）。试验组总有效率85.3%，对照组总有效率62.5%，试验组有1例死亡，病死率为2.9%，对照组有 3例死亡，病死率为9.3%（P<0.05）。结论 NIPPV 治疗 AECOPD 并呼吸衰竭疗效确切，可降低患者病死率。

The Study in clinical application of non-invasive positive pressure ventilation for AECOPD and respiratory failure

Objective To assess the efficacy of NIPPV for AECOPD patients. Methods A total of 66 patients suffering from respiratory failure due to exacerbation of COPD were divided into two groups:treatment group(33 cases) ,with the routine treatment on basis of NIPPV treatment,and control group(33 cases) with only routine treatment .observation indexes include vital signs (breathing rate (RR), heart rate (HR), blood oxygen saturation(SaO2)and arterial blood gas index(arterial blood acidity(pH), arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide (PaCO2).Results After treatment in both groups, in the treat group , breathing rate(RR), heart rate (HR),blood oxygen saturation (SaO2),arterial blood acidity (pH),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide (PaCO2) were improved significantly after treatment compared with the control group (P<0.05).The treatment group total effectiveness is 85.3%, while the other 62.5%. And the treatment group has one death, the death rate is 2.9%, anther group with three deaths, the case fatality rate was 9.3% (P<0.05) .Conclusion It is clinical sure that NIPPV ventilator had good effect on treating COPD with respiratory failure. At the same time, the fatality rate is decreased.