无创正压通气治疗稳定期慢性阻塞性肺疾病的疗效

无创正压通气(noninvasive positive pressure ventilation,NPPV)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重期和稳定期患者中都有广泛应用.对于急性加重期患者,NPPV可显著降低气管插管率、病死率、住重症监护病房(ICU)时间及住院时间等.对于稳定期患者,NPPV能显著改善呼吸困难症状及部分肺功能指标、提高PaO2水平、缓解呼吸肌疲劳、增强活动耐力以及改善睡眠和生活质量,但对于NPPV能否显著降低PaCO2水平,降低住院率、病死率、住ICU时间以及住院时间等,尚存在较大争议.充分了解NPPV在稳定期COPD患者中的疗效,对于提高NPPV的临床应用水平具有重要意义.

Treatment outcome of noninvasive positive pressure ventilation in stable chronic obstructive pulmonary disease

Noninvasive positive pressure ventilation(NPPV)is being widely applied in patients with exacerbating and stable chronic obstructive pulmonary disease(COPD).The use of NPPV in patients with acute exacerbation of COPD has been shown to reduce the need for intubation and mortality,and shorten the length of ICU stay and hospital stay.And the use of NPPV in patients with stable COPD has been shown a significant improvement in dyspnoea,breathing pattern,arterial oxygen tension,respiratory muscle function, exercise tolerance,sleep and quality of life.However,there was no consistent evidence to confirm that NPPV can decrease arterial carbon dioxide tension,reduce hospital admissions and mortality,and shorten the length of ICU stay and hospital stay in patients with stable COPD.Therefore,comprehensive understanding the treatment outcome of NPPV in patients with stable COPD is very important to improve the.application of NPPV.