双水平无创正压通气治疗慢性阻塞性肺疾病伴意识障碍疗效研究

目的:探讨双水平无创正压通气（BiPAP）对慢性阻塞性肺疾病（COPD）并发重度呼吸衰竭伴有意识障碍患者的治疗效果。方法:将42例慢性阻塞性肺疾病并发重度呼吸衰竭伴有意识障碍的患者随机分成两组:常规组和BiPAP组。BiPAP组在常规治疗基础上,同时给予BiPAP通气治疗,比较两组患者在血气分析指标、住院时间、有效率、无效率、死亡率等方面的差异。结果:BiPAP组治疗（2～12）h后有13例患者神志转清,（12～24）h后有5例患者神志转清;常规组（2～12）h后有4例患者神志转清,（12～24）h后有10例患者神志转清。常规组和BiPAP组pH值和PaO2均升高,PaCO₂均下降（P<0.01）,BiPAP组的改善程度明显优于常规组,统计学有明显差异（P<0.05）。结论:BiPAP可以用于慢性阻塞性肺疾病并发重度呼吸衰竭伴有意识障碍患者,其疗效确切。

The Efficacy of Bi-level Positive Airway Pressure (BiPAP) in the Treatment of Chronic Obstructive Pulmonary Disease (COPD) with Disturbance of Consciousness

Objective:To investigate the efficacy of BiPAP in the treatment of COPD with severe respiratory failure associated with unconscious patients.Methods:42 patients with COPD and severe respiratory failure associated with consciousness were randomized divided into conventional group and BiPAP group.BiPAP group was given BiPAP on the basis of conventional treatment,and compared the differences in indication of blood gas,length of hospital stay,efficient,inefficient,mortality.Results:13 patients had clear consciousness after 2～12h and 5 patients switched to clear consciousness after 12～24h in the BiPAP group;4 patients had clear consciousness after 2～12h and 10 patients switched to clear consciousness after 12～24h in the conventional group.The value of PH and PaO₂ elevated while PaCO₂ decreased,with P<0.01;the degree of improvement was significantly superior to the conventional group,with P<0.05.Conclusions:BiPAP can be used for COPD associated with severe respiratory failure with unconscious patients,and it has curative effect.