无创正压呼吸机辅助通气治疗COPD合并呼吸衰竭的临床疗效

目的 探讨无创正压呼吸机辅助通气( BiPAP)治疗慢性阻塞性肺病(COPD)合并呼吸衰竭的临床疗效.方法 选取2009年1月至2012年2月我院收治的68例COPD合并呼吸衰竭患者,将其随机分为治疗组(34例)和对照组(34例),对照组给予抗感染、止咳、化痰、平喘、解痉等常规治疗,治疗组在此基础上加用BiPAP呼吸机辅助通气治疗.观察并比较两组患者治疗前、后呼吸频率、心率、气血指标及病情改善情况.结果 治疗72 h后,治疗组患者呼吸频率及心率显著优于对照组[(20±3)次/min vs.( 26±3)次/min,(91±11)次/min vs.( 109±12)次/min,P＜0.05],pH、Pa02、FV1、FV1/FVC显著高于对照组(P＜0.05),PaC02显著低于对照组(P＜0.05),而对照组各指标治疗后与治疗前比较差异无统计学意义(P＞0.05).治疗期间均无严重不良反应发生.结论 无创正压呼吸机辅助通气治疗COPD合并呼吸衰竭的临床疗效确切,可明显缓解患者呼吸困难,改善动脉血气及肺功能,值得临床推广应用.

Noninvasive positive pressure ventilation for chronic obstructive pulmonary disease with respiratory

Objective To explore the clinical efficacy of noninvasive positive pressure ventilation in the treatment of chronic obstructive pnlmonary disease （ COPD ） with respiratory failure. Methods 68 patients with COPD and respiratory faolure who had been treated from January 2009 to February 2012 in our hospital were randomly divided into study group （ 34 patients ） and control group （ 34 patients ）. The control group received conventional therapies for infection control and symptomatic treatment; while the study group received mechanical ventilation with BiPAP on the basis of routine therapies. Respiratory rate, heart rate, and arterial blood gas were observed and compared between the two groups. Results 72h after treatment, the respiratory rate and heart rate were significantly better in the study group than in the control group （ P〈 0.05 ）, pH, PaO2, FV1, and FV1/FVC were significantly higher in the study group （ P〈 0.05 ）, whereas PaCO2 was significantly lower（ P〈 0.05 ）, while no significant changes occurred in the control group as compared with the baselines （ P 〉 0.05 ）. No severe adverse reactions occurred during treatment. Conclusions Noninvasive positive pressure ventilation is effective in the treatment of COPD with respiratory failure. It can significantly relieve dyspnea and obviously improve arterial blood gas and lung function. It is worth popularizing clinically.