双水平正压通气联合雾化吸入在高龄患者慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭治疗中的应用

目的：观察双水平气道正压通气（BiPAP）联合雾化吸入特普他林及布地奈德治疗高龄患者慢性阻塞性肺疾病急性加重期（AECOPD）合并Ⅱ型呼吸衰竭的临床疗效。方法：将68例AECOPD合并Ⅱ型呼吸衰竭高龄患者随机分为对照组33例，观察组35例。对照组给予常规治疗，包括抗感染、解痉平喘、应用BiPAP治疗等。观察组在对照组治疗基础上联合雾化吸入特普他林及布地奈德。比较2组治疗前及治疗后1周临床症状、血气分析的变化及住院时间。结果：2组患者治疗后临床症状、血气分析均较治疗前改善（P〈0．05-P〈0．01），观察组住院时间少于对照组（P〈0．01）。结论：BiPAP联合雾化吸入特普他林与布地奈德治疗高龄患者AECOPD合并Ⅱ型呼吸衰竭具有良好的临床效果。

Bi-level positive airway pressure respirator combined with aerosolization inhalation for the treatment of acute exacerbation of chronic obstructive pulmonary disease accompanied by type H respiratory failure in the elderly

Objective： To explore the clinical effect of bi-level positive airway pressure （BiPAP） respirator combined with aerosolization inhalation in the treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） accompanied by type II respiratory failure. Methods：Sixty-eight elderly patients with AECOPD accompanied by type II respiratory failure were randomly divided into control group（33 cases） and experiment group（35 cases）. The control group were given the routine therapy such as antibiotics, cleaning the airway and BiPAP ventilator, and the experiment group were given inhalation of terbutaline sulfate and hudesonide in addition. The changes of the clinical manifestation, arterial blood gas analysis before and after treatmen, and the time of hospital stay were compared between the two groups. Results：The clinical manifestation and blood gas analysis of the two groups improved significantly after the therapy（P 〈 0.05 to P 〈 0.01 ） ; the average hospital stay of the experiment group was much shorter than that of the control group （ P 〈 0. 01 ）. Conclusions ： BiPAP ventilation combined with aerosolization inhalation is effective on elderly patients with AECOPD accompanied by type H respiratory failure.