无创正压通气治疗慢性阻塞性肺病并呼吸衰竭

Noninvasive Positive Pressure Ventilation Treatment for Respiratory Failure in Patients with Chronic Obstructive Pulmonary Disease

目的:探讨无创正压通气(NIPPV)治疗慢性阻塞性肺病(COPD)并呼吸衰竭的疗效。方法:选择20例COPD并呼吸衰竭患者为治疗组,22例COPD并呼吸衰竭为对照组,对照组给予常规药物治疗,治疗组给予常规药物治疗联合应用鼻(面)罩进行NIPPV,两组主要观察指标:(1)治疗期间呼吸频率和心率的变化,(2)NIPPV3h后血气分析,(3)观察住院时间,气管插管率及住院病死率,结果:治疗组经NIPPV3h后,呼吸频率下降,心率降低,PaO2明显增加,PaCO2显著下降,PH值改善(P均<0.05),对照组治疗3h后各指标无明显改变(P均>0.05)。治疗组气管插管率和住院病死率与对照组相比,显著降低,住院时间缩短(P均<0.05)。结论:无创正压通气对COPD并呼吸衰竭是一种比较安全、切实有效的呼吸支持手段。

Objective:To investigate the effect of noninvasive positive pressure ventilation treatment for respiratory failure in patients with chronic obstructive pulmonary disease.Methods: Tweenty patients with COPD complicated with respiratory failure were selected for therapy group; 22 patients with same diseases were for control group. Usual medical therapy was used for control group,while NIPPV plus usual medical therapy was used for therapy group. Major observed subjects:(1)Respiratory rate and heart rate.(2)Blood and gas analysis after three hours for MIPPV.(3) The staying time in hospital,bronchi incubation and fatality rate. Results:In therapy group after three hours for NIPPV,The respiratory rate and heart rate decreased,The PaO2 increased significantly, The PaCO2 decreased obviously,PH was changed (all P<0.05=.In control group, all observed subjects did not changed obviously (all P>0.05). Compared with control group,the bronchi incubation and fatality rate decreased significantly and the staying time in hospital shorten in therapy group. (all P<0.05=.Conclusion: Noninvasive positive pressure ventilation for respiratory failure in patients with COPD is a comparative safe and actual effective method of respiratory support.