无创通气治疗慢性阻塞性肺疾病急性发作合并呼吸衰竭的疗效观察

目的 研究无创机械通气对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并Ⅱ型呼吸衰竭的疗效.方法 将207例慢性阻塞性肺病合并Ⅱ型呼吸衰竭患者随机分为治疗组(n=104例)和对照组(n=103例).治疗组与对照组均给予抗感染、舒张支气管、止咳化痰、氧疗,治疗组在此基础上给予无创机械通气辅助治疗.观察治疗前后患者呼吸困难缓解程度和治疗后4h、48 h的动脉血气分析、平均住院时间及住院病死率.结果 治疗组给予无创通气后,动脉血气PaO2明显上升(P＜0.05),PaO2下降明显(P＜0.05).结论 双水平无创正压机械通气对慢性阻塞性肺病合并Ⅱ型呼吸衰竭的治疗效果好,缓解速度快,有效,明显缩短患者平均住院时间及降低住院病死率.

Therapeutic effect observation of non-invasive positive pressure ventilation on acute exacerbation of chronic obstructive pulmonary disease accompanied with respiratory failure

Objective To study the clinical efficacy of non-invasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease(COPD) patients with type Ⅱ respiratory failure.Methods Two hundred and seven patients with COPD with type Ⅱ respiratory failure were divided into the treatment group(104 cases) and control group(103 cases).Anti-infection,eliminating phlegm,relieving asthma and oxygen therapy were given to both groups and the treatment group was treated with bi-level positive airway pressure(BiPAP) ventilation in addition to above routine treatment.Dyspnea relieving degree,the artery blood gas were obtained at the 4 h,48 h.Average length of stay and hospital mortality were observed before and after the treatment.Results PaO2 and PaCO2 changed more significantly in treatment group than that in the control group(P<0.05).Conclusion BiPAP is definitely valuable for treatment of COPD patients with type Ⅱ respiratory failure and can shorten the mean hospital time and reduce hospital mortality.