摘要
目的:观察使用双水平无创正压通气(BiPAP)模式治疗慢性阻塞性肺疾病(COPD)所至严重呼吸衰竭的临床疗效和副作用.方法:用无创正压通气(NPPV)治疗COPD所至严重呼吸衰竭患者54例(昏迷组27例,非昏迷组27例),观院,广东佛山528000)察平均住院日、气管插管率、病死率以及通气前后心率及血气指标变化.未使用呼吸机的常规治疗组26例做为对照.结果:NPPV组住院时间缩短,气管插管率和住院病死率下降,与常规治疗组比较有统计学差异;NPPV治疗组无论是昏迷患者还是非昏迷患者通气后心率下降、血气指标改善,与通气前比较有统计学差异.结论:用BiPAP模式行NPPV是治疗COPD所至严重呼吸衰竭的有效方法,合并意识障碍的患者也有效,及早应用能迅速缓解病情,缩短住院时间,降低病死率.
AIM: To investigate the clinical effect of noninvasive positive pressure ventilation (NPPV) on chronic obstructive pulmonary disease (COPD) complicated by severe respiratory failure. METHODS: Eighty COPD patients with severe respiratory failure were divided into 2 groups (conventional therapy group and NPPV group ). And the NPPV group included 27 coma cases and 27 non-coma cases. The conventional therapy group included 26 non-coma cases. Arterial blood gas ( ABG), days of NPPV, success ratio and adverse effects were investigated. RESULTS: NPPV increased PaO2 significantly, declined PaCO2 significantly and elevated blood pH. And NPPV decreased the rate of endotracheal intubation, length of stay and case-fatality rate. There were significant differences between the NPPV group and conventional therapy group( P 〈 0.05 ). And NPPV could significantly improve(P 〈0.05) artery blood gases rapidly in both of coma and non-coma cases after the therapy, but there was no significant difference between the coma and the non-coma cases (P 〉 0.05 ). CONCLUSION: NPPV is effective for COPD patients with severe respiratory failure. It can improve artery blood gases rapidly, decrease the rate of endotracheal intubation, length of stay and case-fatality rate. Coma is not the absolute contraindication of NPPV treatment.
出处
《第四军医大学学报》
北大核心
2007年第22期2079-2081,共3页
Journal of the Fourth Military Medical University
基金
佛山市卫生局资助(佛卫[2005]192号)
关键词
慢性病
肺疾病
阻塞性
呼吸功能不全
正压呼吸
chronic disease
lung diseases, obstructive
respiratory insufficiency
positive-pressure respiration