无创通气在慢性阻塞性肺疾病急性发作期伴呼吸衰竭治疗中的应用

Application of non-invasive ventilation(NIV)in treating chronic obstructive pulmonary diseace(COPD)associated with respiratory failure

目的 探讨无创通气在慢性阻塞性肺疾病 (COPD)急性加重期 (AE)的应用价值。方法 急性加重期COPD患者 91例 ,分为无创通气组和有创通气组 ,观察患者上机前、上机后 30min、上机后 2d血气分析变化、机械通气天数、住院天数、花费与并发感染等指标。结果 有创通气 30min后PaO2 的升高、PaCO2 下降、pH的恢复明显快于无创通气组 (P <0 0 1)。但 2d后两组PaO2 、PaCO2 、pH差异无显著性 (P>0 0 5 )。无创通气组机械通气天数、住院天数、费用、以及院内感染的发病率明显低于有创通气组 (P <0 0 1)。无创通气组明显嗜睡者 12例 ,占 2 7 3% ,10例经无创通气治疗后清醒 ,无需气管插管有创通气。

Objective To study the effect of NIV in treating COPD with respiratory failure.Methods 91 COPD patients at acute exacerbation were divided into NIV group and PPV group.The changes of blood gas analysis before ventilation,30 minutes and 2 hours after ventilation were measured.Days of ventilation,days of admission,cost,and secondary infection were recorded.Results The increase of PaO 2 and pH,and the decrease of PaCO 2 30 minutes after ventilation in PPV group were faster than those in NIV group(P<0.01).However,there were no any differences in the PaO 2,PaCO 2,and pH between the two groups 2 hours after ventilation(P>0.05).The days of ventilation,the days of admission,cost,and secondary infection in NIV group were lower than those in PPV group(P<0.01).10 patients in NIV group were lower or drowsy,who woke after NIV.Conclusion NIV is a cheap and effective method in treating COPD patients associated with respiratory failure.