双水平气道正压通气治疗慢性阻塞性肺疾病急性加重患者的临床研究

目的探讨双水平气道正压通气(BIPAP)对慢性阻塞性肺疾病急性加重(AECOPD)患者的治疗作用。方法回顾性分析2008年1月-2011年1月收住皖北煤电集团总医院ICU的AECOPD合并呼吸衰竭患者的临床资料。根据患者入科时采取的机械通气模式,分为SIMV组和BIPAP组。比较两组患者通气前和通气48 h时的呼吸频率(RR)、心率(HR)、平均动脉压(MAP);动脉血pH值、血氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(OI)等血气指标,以及治疗结束后镇静剂的总用量、机械通气时间等。结果纳入研究的AECOPD患者43例,男性17例,女性26例;SIMV组15例,BIPAP组28例。机械通气48 h时RR和HR两组间比较,SIMV组

Clinical Study of Bi-level Positive Airway Pressure Ventilation in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective To evaluate the effect of bi-level positive airway pressure ventilation(BIPAP) in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The clinical data of patients with AECOPD in ICU of the center hospital of Wanbei Coal-Electricity Group CO.from January,2008 to January,2011 were studied retrospectively.They were divided into SIMV group and BIAPA group according to different ventilation modes.Clinical index in two groups including respiratory rate(RR),heart rate(HR),mean artery pressure(MAP),blood gas indexes such as the value of pH of arterial(pH),pressure of arterial oxygen(PaO2),pressure of arterial carbon dioxide(PaCO2),oxygenation index(OI) and the dosage of sedation and duration of mechanical ventilation were contrasted.Results There were 43 patients(M17,F26,45-78 years old) with AECOPD enrolled,divided into two groups: SIMV group(15 cases) and BIAPA group(28 cases).48 h after the ventilation,RR and HR were significantly higher in BIPAP group than that in SIMV group(P<0.05),at the end of ventilation,the total dosage of midazolam administered to these patients was significantly higher in SIMV group than in BIPAP group(P<0.05).Conclusion Compared with P-SIMV mode,BIPAP is an effective mode of mechanical ventilation therapy for patients with AECOPD.It reduces the dosage of tranquilizer.