双水平气道正压无创通气治疗慢性阻塞性肺疾病合并呼吸衰竭临床研究

目的 探讨双水平气道正压无创通气（BiPAP）对慢性阻塞性肺疾病（COPD）Ⅱ型呼吸衰竭的治疗效果. 方法 42例COPDⅡ型呼吸衰竭患者随机分成治疗组（22例）和对照组（20例）,对照组给予常规抗感染、平喘、祛痰和低浓度氧疗,治疗组除了常规治疗外,加无创机械通气（BiPAP）治疗,观察治疗前后动脉血气中pH、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）的变化. 结果 治疗后治疗组和对照组pH、PaO2均升高,PaCO2下降治疗组分别为（7.38±0.10）、（94.1±4.9）mm Hg（1 mm Hg=0.133 kPa）、（42.7±4.3）mm Hg,对照组分别为（7.36±0.11）、（69.7±3.6）mm Hg、（69.1±3.8）mm Hg],与治疗前相比,差异有统计学意义（P＜0.05）;但治疗组治疗前后PaO2升高与PaCO2下降的差值均高于对照组,差异有统计学意义（P＜0.01）. 结论 BiPAP通气可作为COPD并呼吸衰竭的一线治疗手段.

Clinical research of BiPAP treatment on chronic obstructive pulmonary disease with respiratory failure

Objective To investigate the bi-level positive airway pressure non-invasive ventilation(BiPAP)for chronic obstructive pulmonary disease(COPD)patients with type Ⅱ respiratory failure of the therapeutic effect. Methods Totally 42 cases of COPD patients with type Ⅱ patients with respiratory failure were randomly divided into treatment group(22 cases)and control group(20 cases).Control group was given conventional anti-infection,asthma,expectorant,and low concentrations of oxygen.Besides conventional therapies,patients in treatment group accepted bilevel positive airway pressure(BiPAP).Changes of pH,PaO2 and PaCO2 in arterial blood of all patients were observed. Results After treatment,pH,PaO2 were increased,PaCO2 decreased in the treatment group and the control group compared with those before treatment(P ＜ 0.05).The extension of PaO2 and PaCO2 in treatment group was larger than that in the control group. Conclusion BiPAP ventilation can be used as first-line treatment of COPD and respiratory failure.