双水平气道在治疗慢性阻塞性肺病急性加重期呼吸衰竭时的应用

Application of the Bi-Level Positive Airway Pressure in COPD Patients with the Acute Respiratory Failure

目的评价双水平气道正压(BiPAP)鼻/面罩式无创通气在慢性阻塞性肺病(COPD)并发呼吸衰竭急性加重期治疗中的作用。方法观察62例COPD并发呼吸衰竭急性加重期患者,应用BiPAP鼻/面罩式无创通气前、后血气、呼吸和心率的变化。结果62例患者经无创通气好转出院54例(87·1%),无创通气4h及无创通气治疗结束时较通气前的血气和体征明显改善(P<0·05),另外8例病情恶化改为有创通气后好转。结论BiPAP无创通气可有效治疗COPD并发呼吸衰竭的急性加重期患者,减少有创通气的应用。

Objective To evaluate the effect of noninvasive Bi - level Positive Airway Pressure （BiPAP） ventilation on the Chronic Obstructive Pulmonary Disease （COPD） patients with type -Ⅱ respiratory failure in the period of acute exacerbation. Methods Totally 62 cases with COPD complicated with respiratory failure in the period of acute exacerbation were included. The changes of the blood gas analysis, respiratory rate and the heart rate were observed before and after the application of the noninvasive BiPAP ventilation. Results In 62 cases, 54 cases （ 87. 1% ） were improved after the noninvasive BiPAP ventilation. At the 4 hour and the whole period of the ventilation, the signs and the blood gas analysis of the patients were improved significantly （ P 〈 0. 05 ）. The rest deteriorated 8 cases had been deteriorated after the invasive ventilation. Conclusion The application of the noninvasive BiPAP ventilation can be a effective method in treatment of COPD patients with acute respiratory failure in the period of acute exacerbation, and reduce application of the invasive ventilation,