面罩BiPAP通气治疗COPD合并呼吸衰竭的疗效观察

目的　探讨面罩 Bi PAP通气治疗 COPD合并呼吸衰竭的疗效。方法　 30例 COPD合并呼衰患者随机分为 Bi PAP通气加常规疗法组 (试验组 )和单用常规疗法组 (对照组 )各 1 5例 ,试验组设置参数 :IPAP由 8- 1 0cm H2 O开始 ,渐升至 1 4 - 2 0 cm H2 O、EPAP2 - 5 cm H2 O,氧流量 5 - 1 0 L / min。定期记录病情变化、血气、参数及治疗时间等 ,若病情及血气进行性恶化 ,予以气管插管。结果　需气管插管者 ,对照组 1 5例有 1 1例 (73% ) ,而试验组1 5例有 3例 (2 0 % )有显著减少 (P<0 .0 5 ) ;通气 1 h试验组 Pa O2 明显增高 (P<0 .0 5 ) ,心率和呼吸频率明显减少 (P<0 .0 5 ) ;通气 1 2 h试验组 Pa CO2 显著降低 ,酸中毒明显改善 (P<0 .0 5 )。结论　面罩 Bi PAP通气可作为 COPD并呼衰的一线治疗手段

Observations on the effects of the mask BiPAP ventilation''''s curing COPD and acute respiratory failure

Objective To evaluate the effects of the mask BiPAP ventilation on COPD with chromic respiratory failure (CRF).Methods Thirty cases of COPD with CRF were randomly divided into two groups: BiPAP ventilation together with regular therapy group (test group, n=15) and regular therapy group (contrast group, n=15). The test group parameter was IPAP gradually from 8 to 20 cm H 2O, EPAP 2 5CM H 2O, and the flow rate was oxygen 5-10L/min. The patients' condition, blood and vital energy parameter, therapy time etc. were recorded. If the patients' condition, blood and vital energy levels were deteriorating, trachea cannula was performed. Results In the contrast group, there were 11 cases (73%) who needed trachea cannula, while in the test group 3 cases (20%): P<0.05. In the test group, when ventilated for 1 h, PaCO 2 increased significantly (P<0.05) and cardiac rates and respiratory rates decreased significantly (P<0.05). In the test group, when ventilated for 12 h, PaCO 2 decreased significantly and acidosis improved significantly (P<0.05).Conclusion The masked BiPAP ventilation can be used as the number one choice for the treatment of COPD and ARF.