无创机械通气治疗慢性阻塞性肺疾病伴Ⅱ型呼吸衰竭的临床疗效

目的]探讨无创机械通气（NPPV）对慢性阻塞性肺疾病（COPD）伴Ⅱ型呼吸衰竭的治疗作用和意义。方法]对本院60例伴有Ⅱ型呼吸衰竭的COPD患者，在采用基础对症治疗基础上，使用NPPV治疗，观察此方法应用效果以及应用后患者血气分析指标等改善情况。结果]60例COPD伴Ⅱ型呼吸衰竭患者中，56例成功完成NPPV治疗，人机配合较好，成功率为93．3％（56/60），患者症状均有一定好转；治疗后患者平均心率为（86．7＆#177;7．6）次/分钟，呼吸频率为（22．3＆#177;2．2）次/分钟，均较治疗前明显改善（P ＜0．05）；治疗后患者pH为（7．39＆#177;0．07），更接近正常值，动脉氧分压（PaO2）为（77．8＆#177;6．6） mmHg ，较治疗前上升，动脉二氧化碳分压（PaCO2）为（53．5＆#177;3．8） mmHg ，较治疗前下降（ P ＜0．05）。结论]NPPV对患者呼吸功能有显著的改善作用，可纠正呼吸衰竭症状，避免有创通气对患者造成的不良影响。

Clinical Efficacy of Noninvasive Positive Pressure Ventilation in the Treatment of Chronic Obstruc-tive Pulmonary Disease with Type Ⅱ Respiratory Failure

Objective] To explore the clinical efficacy and significance of noninvasive positive pressure ventila-tion（NPPV） in the treatment of chronic obstructive pulmonary disease（COPD） with type Ⅱ respiratory failure .Methods] A total of 60 COPD patients with type Ⅱ respiratory failure in our hospital were treated with NPPV based on primary symptomatic treatment .The application efficacy of this method and the improvement of blood gas analysis were observed .Results] Among 60 COPD patients with type Ⅱ respiratory failure ,56 patients suc-cessfully completed NPPV ,and patients went with the machine well ,and the success rate was 93 .3% （56/60） . Symptoms of patients were improved .After treatment ,the average heart rate of patients was 86 .7 ＆#177; 7 .6 and re-spiratory frequency was 22 .3 ＆#177; 2 .2 ,which were significantly improved compared with before treatment .After treatment ,pH was 7 .39 ＆#177; 0 .07 ,which was more close to the normal value ,and PaO2 was （77 .8 ＆#177; 6 .6）mmHg , which was increased compared with before treatment ,and PaCO2 was （53 .5 ＆#177; 3 .8）mmHg ,which was decreased compared with before treatment （ P＆lt;0 .05） .Conclusion] NPPV can improve respiratory function of patients ob-viously ,and correct respiratory failure symptoms ,and avoid adverse effects caused by invasive ventilation .