BiPAP无创机械通气治疗COPD合并Ⅱ型呼吸衰竭的疗效对照

目的探讨双水平无创BIPAP呼吸机对COPD合并Ⅱ型呼衰的治疗效果。方法 38例COPD合并Ⅱ型呼衰患者随机分二组,治疗组和对照组,后者给予常规抗感染、平喘、祛痰等对症治疗和持续低流量给氧,治疗组除常规治疗外加BIPAP无创通气,采用口鼻面罩通气,S/T模式,逐渐调高吸气压力(IPAP)呼气压力(EPAP)到适当水平,氧浓度37%,保持SPO_290%以上通气时间1周,每天2次,每次3h。结果治疗组治疗后ABG中PH值和PaO_2逐渐上升,PaCO_2值下降明显,临床症状改善,呼吸频率,心率均减慢,呼吸困难好转。结论本方法治疗COPD合并Ⅱ型呼衰的治疗效果明显,减少气管插管或气管切开所带来的并发症可能。

Objective To investigate the bi-level non-invasive BIPAP ventilator-Ⅱ-type of COPD combined treatment of respiratory failure.Methods 38 patients with COPD combined typeⅡrespiratory failure were randomly divided into two groups,treatment group and control group,which is given to conventional anti-infective,anti-asthmatic,expectorant, such as symptomatic treatment and sustained low-flow oxygen,the treatment group in addition to conventional therapy plus BIPAP non-invasive ventilation,the use of nose and mouth mask ventilation,S / T model,a gradual increase in inspiratory pressure(IPAP) expiratory pressure(EPAP) to the appropriate level of 37%oxygen concentration to maintain SPO2 90%above the ventilation time a week,day 2 times,each time 3.After treatment,the results of ABG in the pH value and PaO_2 gradually increased,PaCO_2 decreased significantly,to improve the clinical symptoms,respiratory rate,heart rate had slowed down,difficulty breathing improved.Conclusion The combined treatment of COPD typeⅡrespiratory failure of the treatment effect to reduce tracheal intubation or tracheostomy may be caused by complications.