无创正压通气治疗慢性阻塞性肺病急性加重期合并呼吸衰竭的疗效观察

Clinical efficacy of Noninvasive positive pressure ventilation on acute exacerbations of respiratory failure

目的 探讨无创正压通气（NPPV）治疗慢性阻塞性肺病（COPD）急性加重期合并呼吸衰竭的价值。方法 对46例COPD合并呼吸衰竭病人中23例采用NPPV治疗者（治疗组）与23例采用常规药物治疗者（对照组）进行比较。观察治疗后2h、48h心率、呼吸频率、动脉血气分析的改善情况，比较气管插管率，病死率、住院时间。结果治疗组同期心率、呼吸频率、动脉血气分析较对照组明显改善，住院时间缩短，气管插管率、病死率明显降低。结论 NPPV是治疗COPD急性加重期合并呼吸衰竭的一种有效方法，可提高氧分压、降低二氧化碳分压，缩短病程及降低插管率、病死率。

Objective To evaluate clinical value of noninvasive positive pressure ventilation （NPPV） on the treatment of acute exacerbations of chronic obstructive pulmonary disease （COPD） with respiratory failure. Methods 23 of 46 patients with COPD and respiratory failure were randomized into noninvasive positive pressure ventilation treatment group （trial group） and compare with the other 23 patients with routine drug treatment （control group）. The heart rate, breath rate, the improving lever of blood gas index in 2h and 48h after treatment were observed and the rate of endotracheal intubation, mortality, length of stay were compared. Result Compared with the result of control group, the heart rate ,breath rate, the blood gas analysis index improved significantly and the in-hospitality mortality rate, the mean hospital stay etc decreased in trial group. Conclusion Noninvasive positive pressure ventilation （NPPV） can increase PaO2 as well as decreasing PacO2 and benefit COPD patients with respiratory failure.