经口/鼻面罩双水平气道正压通气治疗慢性阻塞性肺疾病急性加重期并呼吸衰竭

Clinical Application of Noninvasive Bi-level Positive Airway Pressure Ventilation in Patients with Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

目的评价经口/鼻面罩双水平气道正压通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)急性加重期并Ⅱ型呼吸衰竭的应用价值。方法对24例经常规治疗(对照组)和27例经常规治疗加BiPAP治疗(治疗组)的COPD急性加重并Ⅱ型呼吸衰竭患者的临床疗效进行分析。结果BiPAP治疗后2小时、1天、2天、3天的PaO2、PaCO2和pH较治疗前明显改善(P<0.05),症状也较对照组改善明显(P<0.05);气管插管发生率及平均住院时间分别低于和短于对照组(P<0.05)。结论正确应用BiPAP治疗COPD急性加重并Ⅱ型呼吸衰竭,能降低有创机械通气使用频率和缩短住院时间。

Objective To evaluate the clinic effectiveness of by using bi-level positive airway pressure (BiPAP) ventilation via nasal/mouth mask in patients with respiration failure secondary to the acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods 27 patients were submitted to standard therapy (consisting of medical,oxygen and physical therapy) plus BiPAP and 24 patients to standard therapy.Clinic manifestation (including respiratory rate,heart rate,blood pressure and conscious) and arterial blood gas analysis before and after 2 hours,1day,2days,3days and 7days of treatment in each group were comparatively analyzed.Results After 2 hours,1day,2days,3days and 7days of treatment by BiPAP,patients showed a significant improvement in PaO2,PaCO2 and clinic manifestation,and there was a significant difference between two groups.Conclusion BiPAP is an effective ventilation pattern for patients with COPD complicated with type II respiratory failure. Application of BiPAP can decrease the duration of hospitalization.