双水平气道正压通气治疗COPD合并慢性呼吸衰竭29例

目的:探讨双水平气道正压通气(BiPAP)对慢性阻塞性肺病(COPD)合并慢性呼吸衰竭的治疗作用。方法:29例COPD合并慢性呼吸衰竭患者应用BiPAP呼吸机进行辅助通气治疗,记录通气前及通气治疗后2 h、12h患者在呼吸室内空气条件下的动脉血气以及肺功能变化。结果:治疗前PaCO2(65±15)mmHg,PaO2(45±15)mmHg,pH(7.28±0.10);FVC(1.25±0.20)L,FEV1(0.65±0.08)L。治疗后2 h,PaCO2(60±13)mmHg,PaO2(75±15)mmHg,pH(7.30±0.12);FVC(1.28±0.18)L,FEV1(0.80±0.10)L。治疗后12 h,PaCO2(58±12)mmHg,PaO2(80±15)mmHg,pH(7.33±0.13);FVC(1.33±0.20)L,FEV1(0.85±0.15)L。治疗前后动脉血氧分压、FEV1比较,差异有统计学意义(P<0.01)。结论:应用BiPAP呼吸机辅助通气治疗COPD合并慢性呼吸衰竭,可提高PaO2,为呼吸衰竭的病因治疗赢得时间。

Effect of Nasal Bi-level Positive Airway Pressure on 29 Chronic Obstructive Pulmonary Disease Patients with Chronic Respiratory Failure

Objective: To investigate the effect of nasal bi-level positive airway pressure(BiPAP) on patients with chronic obstructive pulmonary disease(COPD) complicated with chronic respiratory failure.Methods: All 29 COPD patients with chronic respiratory failure were treat with BiPAP.The arterial blood gas were analysed and the parameters of lung ventilation function were measured before BiPAP and 2 and 12 hours after treatment.Results: Before BiPAP treatment,the parameters of arterial blood gas and lung ventilation function were PaCO_(2)(65±15) mmHg,PaO_(2)(45±15) mmHg,pH(7.28±0.10),FVC(1.25±0.20) L,FEV_(1)(0.65±0.08) L,respectively.Two hours after BiPAP,the parameters changed as PaCO_(2)(60±13) mmHg,PaO_(2)(75±15)mmHg,pH(7.30±0.12),FVC(1.28±0.18) L and FEV_(1)(0.80±0.10) L,respectively.And 12 hours after treatment,the parameters are PaCO_(2)(58±12) mmHg,PaO_(2)(80±15)mmHg,pH((7.33)±0.13),FVC(1.33±0.20) L and FEV_(1)(0.85±0.15) L.Both the levels of PaO_(2) and FEV_(1) had significant changes after the use of BiPAP.(Conclusion:) Nasal BiPAP may be considered a good treatment option for patients with COPD complicated with chronic respiratory failure due to its good improvement of PaO_(2) and FEV_(1).