经口/鼻面罩双水平气道正压通气抢救慢性阻塞性肺疾病加重期呼吸衰竭

目的　探讨经口 /鼻面罩双水平气道正压通气 (BiPAP)对慢性阻塞性肺疾病 (COPD)急性发作并Ⅱ型呼吸衰竭的治疗作用。方法　 31例COPD急性发作并呼吸衰竭患者随机分成 2组 ,试验组采用双水平气道正压通气机治疗 +常规临床治疗 ,对照组仅采用常规临床治疗。比较入院时、治疗 1h、 7d后临床情况 (神志、呼吸频率、心率、血压 )和动脉血气 (pH、PaO2 、PaCO2 、SaO2 )。结果　试验组经BiPAP治疗 1h、 7d后PaO2 较治疗前明显升高 (P <0 0 1) ,PaCO2 明显降低 (P <0 0 1) ,PaO2 升高和PaCO2 降低幅度与对照组相比 ,有显著性差异 (P <0 0 1)。试验组各临床观察指标也较对照组有明显好转。结论　Bi PAP对COPD急性发作合并Ⅱ型呼吸衰竭具有良好的治疗作用。

Treament of respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary diseases through bilevel positive airway pressure ventilation via nasal/mouth mask

Objective To evaluate the clinical effectiveness of by using bilevel positive airway pressure(BiPAP)ventilation via nasal/mouth mask in patients with respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary diseases(COPD).Methods 31 patients were randomly submitted either to standard therapy(consisting of medical,oxygen and physical therapy)plus BiPAP or to standard therapy.Clinical manifestation(including respiratory rate,heart rate,blood pressure and conscious status)and arterial blood gas analysis before and after 1 hour,7 days after treatment in each group were comparatively analysed.Results After 1 hour,7 days of treatment by BiPAP,patients showed a significant improvement in PaO 2,PaCO 2,and clinical manifestation,and there was a significant difference between two groups.Conclusion BiPAP ventilation is effective in patients with respiratory failure during acute exacerbation of COPD.