无创正压通气治疗COPD急性加重期并II型呼吸衰竭临床分析

Non-invasive Positive Pressure Ventilation in Treatment of Acute Exacerbation of COPD with Type II Respiratory Failure

目的研究无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)急性加重期并发II型呼吸衰竭临床效果。方法1999年1月-2005年6月呼吸内科68例住院患者,观察组(NIPPV)33例患者,对照组(非NIPPV组)35例。观察33例NIPPV治疗慢性阻塞性肺疾病急性加重期并发Ⅱ型呼吸衰竭患者的血气分析指标变化(pH值,PaO2,PaCO2),住院病程,气管插管率和病死率,并同未使用NIPPV治疗的35例COPD相似病例进行比较分析。结果33例NIPPV治疗后血气分析各项指标较治疗前有明显改善,住院病程缩短,气管插管率和住院率明显降低,同非NIPPV治疗的对照组比较有显著差异性。结论NIPPV治疗是慢性阻塞性肺疾病急性加重期并发II型呼吸衰竭的一种有效方法,早期应用可能阻止病情的进一步发展,缩短病程。

Objective To study the clinical effect of non - invasive positive pressure ventilation （NIPPV） of chronic obstructive pulmonary disease （COPD） with type Ⅱ respiratory failure. Methods To observe the data of arterial blood gas （ pH, PaO2, PaCO2 ） , the course of disease in hospital , the rate of endotracheal intubation, the mortality of the 68 patients in NIPPV （33 cases） and compare with those of patients （35 cases） without NIPPV treatment. Results The data of 33 cases in arterial blood gas had been improved significantly after NIPPV , the course of disease in hospital was significantly shorter and the rate of endotracheal intubation and mortality of the patients was significantly lower in NIPPV than those in no NIPPV . There was remarkably difference between two groups. Conclusion NIPPV is an effective method in the treatment of acute exacerbation of COPD with type Ⅱ respiratory failure . NIPPV can delay the course of disease if it is applied in early stage.