无创正压通气救治慢性阻塞性肺疾病合并严重Ⅱ型呼吸衰竭的临床研究

目的 评价无创正压通气（NIPPV）救治慢性阻塞性肺疾病（COPD）合并严重Ⅱ型呼吸衰竭的治疗效果。方法 前瞻性研究25例伴严重Ⅱ型呼吸衰竭（PaCO2〉80mmHg）的COPD急性发作期患者，在常规治疗基础上给予NIPPV治疗，并监测血气、临床征象等情况。结果 NIPPV3h迅速改善了患者的心率（HR）、呼吸频率（RR）和血气（PH、PaCO2）（P〈0.01），通气24h可获进一步改善（P〈0.01）。插管率12%，病死率8%。结论 NIPPV是治疗COPD合并严重Ⅱ型呼吸衰竭的有效手段。

Clinical study of noninvasive positive pressure ventilation in severe respiratory failure of chronic obstructive pulmonary disease

Objective To evaluate noninvasive positive pressure ventilation(NIPPV)in acute exacerbations of chronic obstructive pulmonary disease(COPD).Methods 25 cases of severe respiratory failure due to COPD(PaCO2>80 mm Hg)were prospectively investigated,Blood gas,clinic signs were monitored before,during and after continous NIPPV.Results Heart rate,respiratory rate and arterial blood gases(PH,PaCO2)were improved rapidly 3 h after treatment(P<0.01),and further improved 24 h after treament(P<0.01),the rate of intubation was 12% and the hospital mortality was 8%.Conclusions NIPPV is an effective therapy in severe respiratory failure due to COPD.