经口鼻面罩双水平气道正压通气治疗慢阻肺合并Ⅱ型呼吸衰竭的临床意义

The Clinical Significance of Treating Respiratory Failure Secondary to the Acute Exacerbation of Chronic Obstructive Pulmonary Diseases through Bilevel Positive Airway Pressure Ventilation via Nasal/mouth Mask

目的经口鼻面罩双水平气道正压通气(B ipap)治疗慢性阻塞性肺病(COPD)合并II型呼吸衰竭的临床意义.方法40例COPD合并II型呼吸衰竭患者随机分成两组;对照组20例予常规的临床治疗;试验组20例采用双水平气道正压通气治疗+常规治疗,并比较入院时,治疗4 h后,1周内的临床疗效.结果试验组B ipap呼吸机治疗后PaO2较治疗前明显升高(P<0.01),PaCO2明显降低(P<0.01).PaO2增高与PaCO2降低与对照组相比有显著性差异,其它临床观察指标也有明显好转.结论B ipap呼吸机对COPD急发合并II型呼衰有良好的治疗作用.

Objective To explore the effectiveness of bilevel positive airway pressure （Bipap） ventilation via nasal/mouth mask in patients with respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary diseases （COPD）. Methods 40 patients were randomly submitted either to standard therapy （consisting of medical, oxygen and physical therapy） plus BiPAP or to standard therapy. Clinical manifestation were comparatively analyzed before and after 4 hours and 7 days of treatment in each group. Results After 4 hours and 7 days of treatment by BiPAP, patients showed a significant improvement in PaCO2 , and clinical manifestation, and there effective in patients with was a significant difference between the two groups. Conclusion Bipap ventilation is respiratory failure during acute exacerbation of COPD.