BiPAP无创呼吸机治疗COPD并Ⅱ型呼吸衰竭56例疗效观察

目的探讨无创正压通气治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的疗效。方法选择我院近年来收治的COPD合并Ⅱ型呼吸衰竭的56例,随机分为治疗组28例,对照组28例。2组均给予抗感染、糖皮质激素、解痉平喘、祛痰、营养支持等常规治疗,对照组予持续低浓度氧疗,治疗组予BiPAP呼吸机面罩正压通气治疗。监测两组治疗前、治疗后24h和48h的血气分析、观察患者的临床症状、生命体征及不良反应。结果两组在治疗24h、48h后血气分析中pH值、PaO2、PaCO2较治疗前均有不同程度的改善,治疗组和对照组比较具有统计学差异(P<0.05)。两组在治疗24h、48h后HR也有所降低,治疗组和对照组比较具有统计学差异(P<0.05)。对照组中1例病情加重,予紧急气管插管行有创通气。结论对于COPD并Ⅱ型呼吸衰竭,早期使用BiPAP,能改善低氧及高碳酸血症降低心率。

Therapeutic Effects of BiPAP Ventilator in COPD with Type II Respiratory Failure Through 56 Patients

Objective To determine the efficacy of noninvasive ventilation with Bi-level positive airway pressure model in treating chronic obstructive ptdmonary disease（COPD） combined with type II respiratory failure. Methods Filly-six patients with COPD combined with type II respiratory failure were randomly divided into two groups, one is control group, received routine therapy, the other is BiPAP group, received noninvasive ventilation on the basis of routine therapy. The blood gas analysis, heart rate was observed before and after treatment. Result After treatment the arterial blood gas was improved in both groups,but BiPAP group was better（P〈0.05）. Heart rate was also reduced in both groups, but BiPAP group was better（P〈0.05）. Conclusion The use of BiPAP ventilator could improve the arterial blood gas, reduce heart rate.Noninvasive ventilation is a valuable method in treatment of COPD patients combined with type II respiratory failure.