无创正压通气治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭的临床观察

Effect of non-invasive positive pressure ventilation in treatment of COPD at acute exacerbation phase combined with typeⅡrespiratory failure in 53 patients

目的观察无创通气(non-invasive positive pressure ventilation,NIPPV)在治疗AECOPD合并Ⅱ型呼吸衰竭患者中的临床疗效。方法治疗组53例AECOPD合并Ⅱ型呼吸衰竭患者在常规治疗的基础上进行NIPPV治疗,对照组53例仅给予常规抗炎、解痉、吸氧等治疗,观察血气指标、心率、血压、呼吸频率及住院时间的变化。结果治疗组和对照组在治疗后动脉血气pH值、PaCO2、PaO2、心率和呼吸频率与治疗前比较均有明显改善。治疗组在降低PaCO2、呼吸频率和提高PaO2方面比对照组效果更明显。结论NIPPV治疗AECOPD合并Ⅱ型呼吸衰竭能更有效地降低PaCO2、呼吸频率,提高PaO2,减少有创机械通气的几率,缩短住院时间。

Objective To observe the clinical effect of non-invasive positive pressure ventilation （NIPPV） in the treatment of chronic obstructive pulmonary disease at acute exacerbation phase （AECOPD） combined with type Ⅱ respiratory failure. Methods Fifty-three patients of therapeutic group were treated with NIPPV, as well as conventional therapeutic managements, such as antibiotic, pacifying gasp, eliminating phlegm, taking respiratory stimulants, and receiving continual low-flow oxygen. Whereas, 53 controls only received conventional intervention. Results There was no significant difference between the 2 groups before the treatment, but significance was found in pH value, PaCO2, PaO2, HR and RR in them. The therapeutic group showed significantly improvement in PaCO2, RR and PaO2 compared with control group. Conclusion NIPPV intervention can effectively lower PaCO2 and RR, improve PaO2, shorten the course of hospitalization.