无创正压通气治疗COPD并Ⅱ型呼吸衰竭48例分析

Treatment effects of noninvasive ventilation on patients who suffered from acute exacerbations of chronic obstructive pulmonary disease (COPD) with typeⅡ respiratory failure.

目的研究无创正压通气(NIPPV)治疗慢性阻塞性肺病急性加重期并发Ⅱ型呼吸衰竭的临床效果。方法回顾性分析2003年1月至2006年10月我院呼吸内科48例NIPPV治疗慢性阻塞性肺病(COPD)急性加重期并发Ⅱ型呼吸衰竭患者,观察治疗前后血气分析的pH、氧分压(PaO2)、二氧化碳分压(PaCO2)、血氧饱和度(SaO2)、心率、呼吸频率等指标变化。结果无创性通气治疗后PaO2、SaO2均明显升高,PaCO2及心率、呼吸频率降低,pH明显改善,经比较差异均有统计学意义(P<0.01)。结论NIPPV是治疗慢性阻塞性肺病急性加重期并发Ⅱ型呼吸衰竭的一种有效方法。

Objective To investigate the clinic significance using noninvasive ventilation（NIPPV） on patients who suffered from acute exacerbations of chronic obstructive pulmonary disease （COPD） with type Ⅱ respiratory failure. Methods This study reviewed 48 patients hospitalized in our respiratory department in 2003 - 2006 with acute exacerbation of COPD, respiratory acidosis and global respiratory failure. The blood gas parameters including pH, PaC02, PaO2 ,SaO2 and the vital signs including heart rate（ HR）, respiratory rate（RR） and blood pressure（BP） were observed before and after utilization of BiPAP ventilator （ manufactured by Weikang company in the U. S. ） in the mode of positive airway pressure ventilation via nasal and facial mask. Results The values of both of PaO2, SaO2, HR and RR greatly increased, the value of PaCO2 greatly decreased, and the value of pH improved significantly. The differences were statistically significant between before and after noninvasive ventilation. Conclusion NIPPV is an effective method in the treatment of patients with severe acidosis due to acute hypereapnic COPD.