无创通气治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的临床研究

目的观察无创通气（NIPPV）治疗慢性阻塞性肺疾病（COPD）急性加重合并呼吸衰竭中的临床效果。方法 2009年12月～2010年12月,所有患者随机分为两组,对照组采用常规治疗,观察组在常规治疗基础上采用NIPPV,比较两组的呼吸、心率及PaO2、PaCO2变化。结果与治疗前比较,对照组治疗后呼吸、心率无明显变化（P〉0.05）,PaO2明显升高（P〈0.05）,PaCO2明显下降（P〈0.05）;观察组治疗后呼吸、心率及PaCO2明显下降（P〈0.05）,而PaO2明显升高（P〈0.05）。并且观察组治疗后呼吸、心率、PaO2、PaCO2改善情况均明显优于同期对照组（P〈0.05）。观察组插管率明显低于对照组（P〈0.05）,住院时间明显短于对照组（P〈0.05）。观察组病死率略低于对照组,但差异无统计学意义（P〉0.05）。结论 NIPPV对COPD急性加重合并呼吸衰竭进行治疗能够明显改善患者呼吸、心率、PaO2及PaCO2,能够明显降低插管率,缩短患者的住院时间,同时其具有无创性,是一项安全、有效的治疗措施。

The clinical study of noninvasive ventilation in treatment with chronic obsUuctive pulmonary disease with respiratory failure

Objective To observe the clinical effect of noninvasive ventilation（NIPPV） in treatment with chronic obstructive pulmonary disease（COPD） with respiratory failure.Methods From December 2009 to December 2010,102 cases with COPD complicated respiratory failure were randomly classified into two groups,which control group with 51 cases were treated with normal therapy and treatment group with 51 cases were treated with NIPPV at the basis of normal therapy.The changes of respiration,heart rate,PaO2 and PaCO2 between the two groups were compared.Results Compared with pretreatment,the respiration and heart rate were not significantly changed（P0.05）,PaO2 was significantly increased（P0.05） and PaCO2 was significantly decreased（P0.05）in control group;the respiration,heart rate and PaCO2 were significantly decreased（P0.05） and PaO2 was significantly increased（P0.05） in observation group（P0.05）.Moreover,after treatment,the respiration,heart rate,PaO2 and PaCO2 in observation group were significantly better than those in control group（P0.05）.The cannula rate in observation group was significantly lower than that in control group（P0.05）.The hospitalized time of observation group was shorter than control group（P0.05）.There was no significant difference in ase-fatality rate between the two groups（P0.05）.Conclusion NIPPV in treatment with COPD with respiratory failure can improve respiration,heart rate,PaO2 and PaCO2,degrade cannula rate,shorten hospitalized time,which is a safe and effective method.