无创正压通气对慢性阻塞性肺疾病呼吸衰竭患者气体交换及转归的影响

为观察无创正压通气对慢性阻塞性肺疾病（COPD）呼吸衰竭患者治疗的价值，分别对60例此病患者给予常规治疗和无创正压通气治疗并观察其疗效。入院时将患者随机分成二组：一组常规治疗基础上应用BiPAP经鼻（面）罩机械通气治疗，另一组给予常规治疗。结果显示：两组患者治疗前pH,PaO2,PaCO2,心率（HR），呼吸频率（RR）差异无显著性，治疗后无创通气治疗组患者上述指标改善十分明显，而常规治疗组除PaO2升高明显外，其他均明显改善。患者恶化需气管内插管的百分率无创通气明组明显低于常规治疗组。提示无创正压通气法能明显纠正COPD呼吸衰竭患者血气交换障碍，降低气管内插管常规机械通气的百分率，是治疗COPD呼吸衰竭的有效方法之一。

Effects of noninvasive positive pressure ventilation on gas exchange and patients' transformation in chronic obstructive pulmonary disease and respiratory failure]

OBJECTIVE: This paper was to observe the effects of noninvasive positive pressure ventilation (NPPV) on gas exchange and patients' transformation and to evaluate their clinical value. METHODS: Patients were randomly treated by either NPPV, or conventional medicine. The arterial blood gas readings, heart rates (HR), and respiratory rates (HR) were obtained at admission after the treatment. It was necessary to intubate when the clinical deterioation was marked by PaCO2 > 70 mmHg, PaCO2 gradually increasing 5-10 mmHg, pH decreasing 0.05-0.1 or mental obstacle, or PaO2 < 45 mmHg. RESULTS: NPPV significantly decreased the PaCO2 level, HR, and RR, significantly increased the PaO2 level, and also decreased the opportunity of intubation. CONCLUSION: The results suggest that NPPV can improve the gas exchange and reduce the need of intubation in COPD patients with acute respiratory failure.