经双通道面罩对慢性阻塞性肺疾病患者进行无创正压机械通气的效果观察

目的 评价经双通道面罩对慢性阻塞性肺疾病患者进行无创正压机械通气的临床效果。方法 选择43例慢性阻塞性肺疾病（COPD）急性加重期并呼吸衰竭患者，随机使用双通道面罩（试验组，22例）或使用单通道面罩（对照组，21例）进行双水平气道正压无创机械通气4小时，通过分析病人的呼吸频率、心率和动脉血气变化，比较两组机械通气的临床效果。结果 两组病人机械通气前后其呼吸频率、心率和动脉血二氧化碳分脏（PaCO2）均显著降低（P〈0．05或P〈0．01），动脉血pH、氧分压（PaO2）均显著增高（P〈0，05或P〈0．01）；双通道面罩组pH增高和PaCO2降低均显著优于单通道面罩组（P〈0．05或P〈0．01）。结论 经双通道面罩和经单通道面罩面罩对COPD合并呼吸衰竭患者进行面罩机械通气（FMMV）均取得良好的临床效果，经双通道面罩对COPD合并呼吸衰竭患者进行FMMV可以减少CO2重复呼吸，更有利于降低PaCO2水平。

The effects of noninvastive positive pressure ventilation through two-way face mask for patients with chronic obstructive pulmonary disease

Objective To evaluate the clinical effects of noninvasive positive pressure ventilation(NPPV)through two-way face mask for patients with chronic obstructive pulmonary disease(COPD).Methods 43 COPD patients with respiratory failure were divided equally at random into two groups:{1}two-way face mask(22 patients),{2}one-way face mask(as control,21 patients),both gropups were treated with double channel noninvasive mechanical ventilator 4 hours,Arterial blood PH,PaO2 and PaCO2 were measured.The changes of respiratory frequency and cardiac rate were recorded in both groups.Results The respiratory frequency,cardiac rate and arterial blood PaCO2 improved prominently(P<0.05 or P<0.01)in and arterial blood pH,PaO2 increased in both groups(P<0.05or P<0.01)before and after the treatment;The increasing of pH and decreasing of PaO2 of trial group were more significant than the control group(P<0.05or P<0.01).Conclusion Both Noninvasive mechanical ventiltion through two-way and one-way face mask are benefit to the treatment of COPD patients with respiratory failure;NPPV through two-way face mask can reduce the rebreathing and decrease the PaCO2 more effectively.