无创正压通气在慢性阻塞性肺病合并呼吸衰竭中的治疗评价

Clinical values of using noninvasive NIPPV ventilation in the treatment of chronic obstructive pulmonary diseases and typeⅡrespiratory failure

目的探讨无创正压通气(NIPPV)在慢性阻塞性肺疾病合并呼吸衰竭的治疗价值。方法选择62例经NIPPV治疗的COPD合并Ⅱ型呼吸衰竭患者与同数量的62例未经NIPPV治疗的COPD合并Ⅱ型呼吸衰竭的患者分为治疗组和对照组,观察两组患者在治疗中的呼吸(RR)、心率(HR)和血气结果改变。结果治疗组患者经NIPPV治疗后症状控制,与对照组比较差异有统计学意义(P<0.01)。结论NIPPV在COPD合并Ⅱ型呼吸衰竭患者的治疗中,具有简便、快捷,患者痛苦少、患者依从性好、并发症少等优点,可以在临床广泛应用。

Objective To explore the clinical values of using noninvasive posmve pressure ventilation （NIPPV） m the treatment of chronic obstructive pulmonary diseases（COPD）and typeⅡ respiratory failure. Methods Sixty-two patients with COPD and type Ⅱ respiratory failure were treated by NIPPV on the basis of routine therapy and followed up. They were divided into two groups： NIPPV success group and NIPPV failure group. The respiratory rate（RR）, heart rate（ HR） and blood gas parameters of the two groups were determined before and after ventilation. Results Dyspnea and blood gas parameters improved markedly in 56 patients after NIPPV therapy,with a success rate 82.4 %. Twelve patients had no response or deteriorated after 48h NIPPV therapy and needed endotracheal intubation and invasive ventilation. The failure rate of NIPPV was 17.6%. Seven patients（ 10. 30/00 ）died and 5 patients（7.4 %）survived. The total suceess rate was 89.9 % in this group. Conclusion The patients with COPD and type Ⅱ respiratory failure should be treated early with NIPPV. If clinical symptoms and blood gas parameters remain unchanged or even deteriorate after 48h NIPPV therapy,invasive ventilation should be used in replacement promptly.