无创机械通气在治疗慢性阻塞性肺疾病合并呼吸衰竭中的应用

目的:探讨慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者应用经口(鼻)面罩双水平气道正压通气(BiPAP)呼吸机正压通气治疗的效果。方法:65例慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者随机分为两组,治疗组33例,采用Bi-PAP 常规治疗,对照组32例,仅采用常规治疗,比较治疗前、治疗2h、24h后两组同期动脉血气及呼吸频率、心率改变。结果:治疗组PaO2、PaCO2、pH值较治疗前明显改善(P<0.05),与对照组比较,差异有显著性(P<0.05);呼吸频率,心率改变也较对照组明显(P<0.05)。气管插管发生率及平均住院天数均少于对照组(P<0.05)。结论:BiPAP是治疗COPD合并Ⅱ型呼吸衰竭经济、有效的方法。

Application of non-invasive positive pressure mechanical ventilation in the treatment of COPD with typeⅡrespiratory failure

Objective:To evaluate the clinical effectiveness by using bilevel positive airway pressure(BiPAP)ventilation via nasal/mouth mask in patients with respiratory failure secondary to the acute exacebation of chronic obstructive pulomonary diseases(COPD).Methods:33 patients were rangdomly submitted to routine therapy plus BiPAP and 32 patients to routine therapy.The cliniacl manifestations(including respiratory rate,heart rate,blood pressure and conscious status) and arterial blood gas analysis before and after 2-hour,24 hour,after treatment in each group were comparatively analyed.Results:After treatment by BiPAP,patients showed a signifycant improvement in PaO2,PaCO2,and clinical manifestation,and there was a significant difference between two groups(P<0.05).Conclusion:BiPAP ventilation is effective in patients with respiratory failure during acute exacerbarion of COPD.