无创正压通气治疗COPD急性加重期合并呼吸衰竭的临床分析

Application of NIPPV in treatment of COPD at acute exacerbation phase combined with Type II respiratory failure

目的 观察NIPPV在治疗COPD急性加重期合并Ⅱ型呼吸衰竭患者中的临床疗效。方法 治疗组2 0 0例COPD急性加重期合并Ⅱ型呼吸衰竭患者在常规抗感染、平喘、祛痰的基础上进行NIPPV治疗,另外同样呼衰的1 0 0例仅给予常规治疗(抗感染、平喘、祛痰和呼吸兴奋剂,持续低流量吸氧)的患者作为对照组。观察NIPPV治疗的临床疗效。结果 两组患者治疗前的基础情况无显著性差异P >0 .0 5。治疗组和对照组在治疗结束时PH、PaCO2 、PaO2 、心率和呼吸频率与治疗前比较均有明显改善,差异有显著性。治疗组在降低PaCO2 、呼吸频率和提高PaO2 方面比对照组效果更明显,统计有显著性差异。治疗组抗生素使用时间和住院时间、住院费用与对照组相比明显减少,且死亡率降低,差异有显著性。结论 COPD急性加重期合并Ⅱ型呼吸衰竭的患者,NIPPV治疗能更有效地降低PaCO2 、呼吸频率和死亡率,提高PaO2 ,缩短抗生素使用时间和住院时间,节约医疗费用。

Objective To observe the clinical effect of NIPPV in treatment of COPD at acute exacerbation phase combined with type II respiratory failure. Methods Two hundreds patients of therapeutic group treated with conventional therapy such as antibiotic, pacifying gasp, eliminating phlegm, respiratory stimulant, continual low-flow oxygen as well as NIPPV. Whereas 100 controls treated with conventional intervention only. Results There was no significant discrepancy statistically between the two groups: P>0.05. Indicators of PH, PaCO2, PaO2, HR and RR of the two groups were significantly ameliorated before and after treatment. The therapeutic group showed significantly more positive effect of lowering PaCO2, RR and improving PaO2 than that of the control group. The therapeutic group had less antibiotic consumption, shorter hospital-stay time, lower fee, and lower fatality rate than that of the control group.Conclusion NIPPV intervention can effectively lower PaCO2, RR and fatality rate, improve PaO2, shorten the course of medication and in-hospital-stay, and reduce medical expenses.