无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭43例临床分析

目的探讨无创正压通气治疗慢性阻塞性肺疾病合并II型呼吸衰竭的临床效果。方法收集呼吸科2010年10月至2011年5月采用无创正压通气呼吸机治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的患者资料,比较治疗前后的临床状况。结果患者经无创正压通气呼吸机治疗后,无论在短期内(24 h,72 h)还是治疗后一段时间内(14 d),临床症状明显改善,二氧化碳分压(PaCO2)显著下降、氧分压(PaO2)显著上升、呼吸性酸中毒明显改善(P<0.05);同时,睡眠呼吸障碍也明显改善:呼吸暂停低通气指数、微觉醒指数、氧饱和度低于90%时间占总睡眠时间百分比均明显下降(P<0.05)。结论以无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者疗效明显,可改善患者临床状况与睡眠呼吸障碍,疗效肯定,值得临床推广使用。

Clinical analysis of treatment of 43 cases of chronic obstructive pulmonary disease combining with type II respiratory failure by noninvasive positive pressure ventilation.

Objective To discuss noninvasive positive pressure ventilation （NIPPV） in the treatment of chronic obstructive pulmonary disease （COPD） companied with type II respiratory failure. Methods Clinical data of COPD with type II respiratory failure patients who were treated with NIPPV from October, 2010 to May, 2011 were collected. Clinical status before and after the treatment were compared. Results After the treatment, both in the short term （24 h, 72 h） and relatively long term （14 d）, clinical symptoms meliorated significantly, PaCO2 decreased significantly, Pa02 increased significantly, respiratory acidosis was significantly ameliorated （ P 〈 0.05 ）. Respiratory disorder during sleep also ameliorated significantly, including decreased apnea - hypopnea index, arousal index, and percentage of time spend when oxygen saturation lower than 90% （ P 〈 0.05 ）. Conclusion NIPPV shows significant efficacy in the treatment of COPD companied with type II respiratory failure, the situation and respiratory disorder during sleep could be much ameliorated, it is effective and worthy of clinical use.