无创正压通气治疗肺心病合并Ⅱ型呼吸衰竭的临床分析

Effect of Non-invasive positive pressure ventilation in the treatment of patients with pulmonary heart disease and typeⅡ respiratory failure

目的:探讨无创正压通气(NIPPV)对肺源性心脏病合并Ⅱ型呼吸衰竭的治疗作用。方法:选择慢性肺源性心脏病(以下简称肺心病)并发Ⅱ型呼吸衰竭的患者40例,随机分为常规治疗组18例(氧疗、常规抗感染、支气管扩张剂、祛痰剂、激素、纠正酸碱失衡的治疗)和NIPPV治疗组22例(常规治疗的治疗基础上,采用经面罩双水平气道正压BiPAPVERSION型呼吸机进行辅助通气)。观察患者动脉血的血气变化及呼吸、心率的改变。结果:治疗3d后,NIPPV组的疗效明显优于常规治疗组(P<0.05)。结论:NIPPV可加速改善肺心病合并Ⅱ型呼吸衰竭患者的病情。

Objective.. To detect the effect of Non-invasive positive pressure ventilation （NIPPV） in the treatment of patients with pulmonary heart disease and type Ⅱ respiratory failure; Methods.. Forty patients with pulmonary heart disease and type Ⅱ respiratory failure were enrolled in the study. The patients were divided randomly into routine therapy group （n=18） and observe group （n=22）. The patients in routine therapy group were treated with routine therapy only and those in observe group were treated with both routine therapy and NIPPV by Bi-level positive airway pres- sure （BiPAP） mode. In each group, parameters of gas exchange, heart rate and respiratory rate were measured before treatment and three days later respectively. Results： The effect of observe group was better than that of routine therapy group （P〈0. 05）. Conclusion： NIPPV can obviously improve several physiological parameters of patients with pulmonary heart disease and type Ⅱrespiratory failure （NIPPV can obviously improve general conditions of patients with pulmonary heart disease and type Ⅱ respiratory failure）.