经面罩双水平正压通气治疗慢性阻塞性肺病合并呼吸衰竭的疗效观察

目的探讨经面罩双水平正压通气（BiPAP）治疗慢性阻塞性肺病（COPD）合并Ⅱ型呼吸衰竭的疗效。方法COPD合并Ⅱ型呼吸衰竭患者53例随机分为2组。治疗组26例,在常规抗炎、解痉、平喘、吸氧、呼吸兴奋剂等治疗基础上,加用BiPAP机辅助通气;对照组27例,仅予上述常规治疗。比较治疗前及治疗2h、24h、48h后2组动脉血气、呼吸频率、心率改变及需插管率等。结果治疗组在予无创通气后2h、24h、48h血气分析中pH值、PaO2均较入院时有明显改善,差异有统计学意义（P（0.05）。PaCO2值在治疗2h后有所下降但不明显,治疗24h后下降明显（P（0.05）。对照组治疗后与入院时比较pH值、PaO2、PaCO2改善不明显,差异无统计学意义（P（0.05）。治疗组改善与对照组比较,差异有统计学意义（P（0.05）,呼吸频率、心率改变也较对照组明显改善（P（0.05）。治疗组理论上需插管的有3例,需插管率11.5%,对照组理论上需插管13例,需插管率48.1%,2组差异有统计学意义（P（0.05）。结论使用无创通气可有效改善COPD合并Ⅱ型呼吸衰竭患者的动脉血气等情况,减少插管率,是治疗此类患者级济有效的方法。

Observation of the effect of Bi-level positive airway pressure to treat COPD to amalgamate breath horizontally by the face guard mask

Objective Bi-level positive airway pressure（BiPAP） to treat the chronic obstructive pulmonary tubercu- losis （COPD） and amalgamate the Ⅱ type and breathe depleted curative effect horizontally by the face guard pair. Methods 53 COPD amalgamate II type breathe depleted patient, divide into, treat 26 of group at random, resist inflammation, solve convulsion, flat breathe heavily, oxygen intake, in the routine resists inflammation, solves convulsion, flat breathing heavily, oxygen intake, breathing excitant etc. and treats the foundation, add and assist and keep in touch with with the BiPAP ma- chine; 27 of control group, give above-mentioned regular treatment only. Treat relatively, treat 2h, 24h, two the intersection of artery and vim and vigour, respiratory rate, the intersection of heart rate and changing and rate of intubate taken, etc. be- hind the 48h. Results The treatment group to obviously improve when pH value, PaO2, PaO2 are relatively admitted to hospi- tal in 2h, 24h, 48h vim and vigour analysis after not achieving and keeping in touch with and the difference has significance （P 〈 0.05）. Control group, and comparative pH value, PaO2, PaO2 improve obviously admitted to hospital, difference have significance （P 〉 0. 05 ）. Treat the group to improve compared with control group, the difference has significance （P 〈 0. 05）. The respiratory rate, heart rate change too relatively the control group obviously improves （P 〈 0.05 ）. Treat group, need to have 3 examples, the rate of intubate taken is 11.5% intubate in theory among them, the control group takes 13 intu- bates in theory, rate of intubate taken is 48.1%, the two difference has significance （ P 〈 0.05 ）. Conclusion It can improve COPD and amalgamate II type situation of vim and vigour which breathes the depleted patient, etc. to keep in touch with effec- tively to achieve to use, reduce the intubate rate, treat this kind of patient grade and help effective method.