无创机械通气在老年COPD合并呼吸衰竭治疗中的应用

Analysis of non-invasive mechanical ventilation in the treatment of elderly COPD with respiratory failure

目的:评价呼吸机无创机械通气治疗老年慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)合并呼吸衰竭的临床疗效。方法:收集我院老年COPD合并呼吸衰竭住院患者61例,其中使用呼吸机无创机械通气为治疗组共24例,未使用者为对照组共37例,两组内科药物治疗相同,治疗组予以呼吸机无创机械通气治疗。结果:呼吸机无创机械通气组中耐受良好者20例,2例不能耐受。治疗后其动脉血氧分压(PaO2)和二氧化碳分压(PaCO2)较治疗前明显改善(P<0.01);与对照组相比,平均住院天数缩短(P<0.05),血气改善时间明显缩短(P<0.01),且治疗组患者血压水平未受到明显影响(P>0.05);也未发生气压伤或呼吸机相关肺炎。结论:经鼻(面)罩呼吸机无创机械通气是治疗老年COPD合并呼吸衰竭的一种安全有效的方法。

Objective：To assess the clinical efficacy of the ventilator treatment of non-invasive mechanical ventilation in the elderly patients with chronic obstructive pulmonary disease （COPD） with respiratory failure. Methods：Collected 61 cases from elderly COPD patients with respiratory failure in our hospital,A total of 24 cases for using ventilator-non-invasive mechanical ventilation was the treatment group, A total of 37 cases for not use was the control group, The two groups were similar to medical treatment,Treatment group to the ventilator treatment of non-invasivemechanical ventilation. Results：The outcome of ventilator-non-invasive mechanical ventilation group, 20 cases of good tolerance, Only two cases can not be tolerated. After the treatment arterial partial pressure of oxygen （PaO2） and carbon dioxide partial pressure （PaCO2） significantly improved than that before treatment （P〈0.01）;compared with the control group, It shortened the average length of stay in hospital （P〈0.05） and the time of blood gas improving, blood pressure levels in patients with the treatment group had no significant effect （P〉0.05）;the ventilator-barotrauma or the ventilator-associated pneumonia did not occur. Conclusion：The nasal （facial） mask respirator non-invasive mechanical ventilation is a safety and effective method to treatment of the elderly COPD patients with respiratory failure.