无创正压通气在慢性阻塞性肺疾病急性加重期治疗中的应用

Application of non-invasive ventilation to COPD patients during acute exacerbation period

目的评价双水平气道正压(BiPAP)无创通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的有效性与完全性。方法对20例AECOPD的住院患者进行BiPAP呼吸机经鼻或口鼻面罩双水平正压通气治疗,监测患者通气前后的生命体征[呼吸(RR)、心率(HR)、血压(BP)]及动脉血气(pH、PaCO_2、PaO_2、SaO_2)的变化,并观察其临床疗效。结果20例AECOPD患者中17例经BiPAP无创通气治疗后,生命体征及动脉血气指标改善,无创通气治疗降低患者PaCO_2,提高了血pH、PaO_2、SaO_2水平,治疗前后的组间差异有统计学意义(P＜0．05)。结论BiPAP无创通气治疗能改善AECOPD患者的生命体征及生理指标,较好地缓解患者的呼吸的疲劳及预防呼吸衰竭的进一步加重,减少插管率。

Objective To evaluate the effectiveness and safety of BiPAP non-invasive ventilation on COPD patients during acute exacerbation（AECOPD）. Methods 20 COPD patients were ventilated using BiPAP non-invasive ventilation through a nose or mouth-nose mask. Their vital signs（RR, HR and BP） and arterial blood gases indicators（pH,PaCO2 ,PaO2 and SaO2 ） before and after ventilation were monitored and the clinical effectiveness was observed. Results The vital signs and arterial blood gases indicators of 17 of the 20 AECOPD patients were improved. PaCO2 was lowered,pH,PaO2 and SaO2 were elevated, and the difference before and after ventilation was statistically significant （P 〈 0.05）. Conclusion BiPAP non-invasive ventilation can improve the vital signs and physiological indicators of AECOPD patients,relieve their respiratory muscle fatigue and prevent them from exacerbation of respiratory failure,thereby lower the need for endotracheal intubation.