经鼻(面)罩机械通气治疗慢性阻塞性肺疾病呼吸衰竭

Using mechanical ventilation via nose or face mask in treating respiratory failure of chronic obstruction pulmonary diseases

目的观察慢性阻塞性肺疾病（ＣＯＰＤ）呼吸衰竭患者经鼻（面）罩机械通气的效果。方法对２９例慢性阻塞性肺疾病呼吸衰竭患者行经鼻（面）罩机械通气。结果治疗后２小时、２４小时、４８小时、１周后，ｐＨ从７．２８±０．１上升至７．３４±０．０７、７．３５±０．０６、７．３８±０．０５、７．３７±０．０７（Ｐ＜０．０１），ＰａＣＯ２从９４．６９±１８．４ｍｍＨｇ下降至８６．０５±２４．６ｍｍＨｇ（Ｐ＜０．０１）、７７．７６±１９．３ｍｍＨｇ（Ｐ＜０．０１）、６８．６０±１１．４ｍｍＨｇ（Ｐ＜０．００１）、６６．６９±２６．９ｍｍＨｇ（Ｐ＜０．００１），ＰａＯ２从５２．７２±１３．１ｍｍＨｇ上升至６４．２５±２４．５ｍｍＨｇ（Ｐ＜０．０５）、６９．０１±１６．６ｍｍＨｇ（Ｐ＜０．００２）、７５．２７±３２．８ｍｍＨｇ（Ｐ＜０．００１）、９１．１６±４０．４ｍｍＨｇ（Ｐ＜０．００１）。临床症状明显改善，有效率７５．９％。结论经鼻（面）罩机械通气对轻、中度的患者有较好的疗效。

Objective To observe effects of mechanical ventilation via nose or face mask in treating respiratory failure of chronic obstruction pulmonary disease (COPD). Method Measuring blood gases of 29 cases with respiratory failure of chronic obstruction lung disease at pre - treatment and in 2,24,48th hours and 7 days after treament by pressure support(PSV)or synchronistic intermittent mandatory ventilation(SIMV). Results pH rose from 7.280.1 at pre KG-*3]- treatment to 7.340.07,7.350.06,7.380.05,7.370.07(all P <0.01) in 2,24,48hours and 7 days after ventilation treatment respectively.PaCO2 dropped from 94.6918.4mmHg at pre - treatment to 86.0524.6,77.7619.3,68.6011.4,66.6926.9mmHg (all P <0.01) in 2,24,48 hours and 7 days after ventilation treatment respectively.PaO2 rose from 52.7213.1 mmHg at pre - treatment to 64.2524.5,69.0116.6,75.2732.8,91.1640.4 mmHg (all P <0.05) in 2,24,48 hours and 7 days after ventilation treatment respectively. Clinical manifestation was significantly improved, total effective rate was 75.9%. Conclusion Mechanical ventilation via nose or face mask was effective for treating mild and moderate severe patients with respiratory failure of chronic obstructive pulmonary disease