NIPPV治疗AECOPD合并昏迷的严重Ⅱ型呼吸衰竭的临床观察

目的：评价无创正压通气（NIPPV）治疗慢性阻塞性肺疾病急性加重期（AECOPD）合并意识障碍的严重Ⅱ型呼吸衰竭（PaC02〉80mmHg）的疗效。方法：31例严重Ⅱ型呼吸衰竭、意识丧失的AECOPD患者，在常规治疗基础上给予NIPPV治疗，并动态监测血气、神志等临床征象等情况。结果：NIPPV治疗可迅速改善患者的意识、呼吸困难、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〈0．05），成功率90．32％，气管插管率9.7％，病死率6．5％。结论：N1PPV是救治AECOPD合并意识障碍、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 Combined with Consciousness Disorder

Objective：To evaluate the effect of noninvasive positive pressure ventilation （NIPPV） in acute exacerbation of chronic obstructive pulmonary disease（COPD）.Methods：31 cases of severe respiratory failure due to COPD（PaC02〉80 mm Hg） combined with consciousness disorder were prospectively investigated, blood gas and consciousness were monitored on the basis of routine treatment and continous NIPPV.Results：The patients of consciousness, heart rate, respiratory rate and arterial blood gases（pH, PaCO2）were improved rapidly after treatment（P〈0.01）, and further improved 24 h after treament（P〈0.01）, the rate of intubation was 9.7%and the hospital mortality was 6.5%.Conclusion：NlPPV is an effective therapy in severe respjratory failure combineded with disorder due to COPD