BiPAP在慢性阻塞性肺气肿并发急性呼吸衰竭的应用研究

目的探讨经口/鼻面罩双水平气道正压通气(B iPAP)在慢性阻塞性肺气肿(COPD)急性发作期并Ⅱ型呼吸衰竭中的临床应用价值。方法65例COPD急性发作并Ⅱ型呼吸衰竭患者随机分为2组,治疗组35例采用B iPAP 常规治疗,对照组30例仅采用常规临床治疗,比较治疗前、治疗2h、24h后两组同期动脉血气及呼吸频率、心率改变。结果治疗组B iPAP治疗后动脉血气分析中的PaO2、PaCO2、pH值较治疗前明显改善(P<0.05),改善与对照组比较,差异有显著性(P<0.05);呼吸频率、心率改变也较对照组明显(P<0.05)。气管插管发生率及平均住院天数均少于对照组(P<0.05)。结论B iPAP是治疗慢性阻塞性肺气肿急性发作期并Ⅱ型呼吸衰竭经济、有效的方法。

Treatment 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 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 35 patients were rangdomly submitted either to standard therapy plus BiPAP and 30 patients to standard therapy.Cliniacl manifestation(including respiratory rate,heart rate,blood pressure and conscious status)and arterial blood gas analysis before and after 2 hour?24hour after treatment in each group were comparatively analyed.Results After 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(P<0.05).Conclusion BiPAP ventilation is effective in patients with respiratory failure during acute exacerbation of COPD.