BiPAP通气对慢性阻塞性肺疾病急性加重并Ⅱ型呼吸衰竭的疗效观察

Efficacy of BiPAP ventilation in Ⅱ type respiratory failure patients with acute exacerbation of chronic obstructive pulmonary disease

目的观察双水平气道内正压通气(BiPAP)对慢性阻塞性肺疾病急性加重(AECOPD)并Ⅱ型呼吸衰竭患者的疗效。方法对56例慢性阻塞性肺疾病急性加重期并Ⅱ型呼吸衰竭的患者采用经鼻(面)罩双水平气道正压通气,动态观察其通气前及通气后2、6、24、72小时的临床表现、生命体征、动脉血气(ABG)、辅助呼吸肌动用评分、呼吸困难评分和呼吸浅快指数(RSBI)的变化。结果BiPAP通气治疗2小时后明显改善动脉血气,降低心率(HR)和呼吸频率(RR),减少辅助呼吸肌参与,通气前后各项观察指标均显著好转(P<0.05)。结论Bi-PAP无创通气能迅速缓解COPD急性加重期并Ⅱ型呼吸衰竭患者的呼吸肌疲劳,改善氧合,从而避免气管插管,疗效显著。

Objective To observe the efficacy of BiPAP ventilation in Ⅱ type respiratory failure patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods Fifty - six cases of acute exacerbation of COPD with Ⅱ type respiratory failure were treated with BiPAP ventilation via face/nasal mask. The chnical manifestations, respiratory rate （ RR）, heart rate （ HR）, arterial blood gases （ABG）, scale for accessory muscle use, dyspnea score and rapid shallow breathing index （RSBI） were compared before treatment, after treatment of 2 hours, 6 hours, 24 hours, and 72 hours. Results ABG, RR, HR and scale for accessory muscle use were improved rapidly at the first 2h in patients, and there was significant difference between before and after ventilations （ P 〈 0.05 ）. Conclusion BiPAP ventilation can rapidly relieve respiratory muscular fatigue and improve gas exchange. It shows effective in treating AECOPD with Ⅱ type respiratory failure.