双水平无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床研究

目的研究无创正压通气(NIPPV)在慢性阻塞性肺疾病(COPD)合并呼吸衰竭中的疗效。方法将65例COPD合并呼吸衰竭患者纳入研究。随机分为标准治疗组(A组,33例),接受常规药物等治疗;NIPPV治疗组(B组,32例),在常规药物治疗的同时,立即应用面罩以双水平正压(BiPAP)模式行NIPPV。比较两组动脉血气分析结果、呼吸频率、心率、插管率、病死率及住院时间等观察指标。结果B组治疗后2~3 h及24 h血气分析中的pH值、PaCO2、PaO2均较入院时改善且差异有统计学意义(P<0.05),而A组与入院时比较差异无统计学意义;其中理论插管率治疗组(5/33)较A组(13/32)低且差异有统计学意义(P<0.05);理论住院时间B组较A组短且差异有统计学意义(P<0.05)。结论BiPAP模式行NIPPV可迅速改善COPD合并呼吸衰竭患者的血气情况,减少插管率与住院时间,是治疗呼吸衰竭的有效手段。

The effect of noninvasive positive pressure ventilation in treating chronic obstructive pulmonary disease complicated with respiratory failure

Objective To research prospectively the effect of noninvasive positive pressure ventilation(NIPPV) in treating chronic obstructive pulmonary disease(COPD) complicated with respiratory failure.Methods Sixty-five cases suffered from COPD complicated with respiratory failure were divided randomly into standard therapy group(group A,n=33) and standard therapy+NIPPV group(group B,n=32) from January 2002 to January 2005.The patients in group A were treated with standard therapy only and those in group B were treated with both standard therapy and NIPPV with bilevel positive airway pressure(BiPAP) mode.Results The levels of blood gas analysis in the study group including pH,PaCO_2 and PaO_2 significantly improved compared with pre-therapy(P<0.05),while in the control group it was negative.Compared with the controls,the theory frequency of cannulas and the theory length of staying in group A were better than those in group B(P<0.05).Conclusion BiPAP can quickly improve the blood gas conditions of COPD complicated with respiratory failure,reduce the frequency of cannulas and length of stay in the hospital.It is a good method to cure respiratory failure.