双水平气道正压通气治疗慢性阻塞性肺疾病急性加重期合并重度高碳酸血症的初步观察

The Initial Observation of Treating Acute Exacerbations of Chronic Obstructive Pulmonary Disease Complicated with Serious Hypercapnia with Bilevel Positive Airway Pressure

目的探讨双水平气道正压通气(BiPAP)治疗慢性阻塞性肺疾病急性加重期(AECOPD)并重度高碳酸血症的可行性。方法19例AECOPD并Ⅱ型呼吸衰竭患者分为两组,常规治疗加BiPAP治疗10例(实验组),常规治疗9例(对照组),观察两组患者的临床症状、辅助检查、血气分析结果、疗效等。结果AECOPD并重度高碳酸血症的Ⅱ型呼吸衰竭病情危重患者治疗有效率80.0%,对照组22.2%(P=0.023)。结论正确应用BiPAP治疗AECOPD并重度高碳酸血症患者,能降低病死率,缩短住院时间,是AECOPD并重度高碳酸血症患者的有效治疗方法之一。

Objective To identify the feasibility of bi-level positive airway pressure in the treatment of the case of acute exacerbation of chronic obstructive pulmonary disease with serious hypereapnia. Methods 19 patients with acute exacerbations of chronic obstructive pulmonary disease complicated with serious hypercapnia divided into two groups： 10 patients treated by standard therapy plus BiPAP（experimental group） and 9 patients were treated by standard therapy （control group）. The symptoms and accessory examinations and the results of blood gas and clinic manifestations in each group were comparatively analyzed. Result After the treatment, the rate of being successful rescued in the experimental group was 80%, obviously higher than that in the control group 22.22 % （P 〈 0.05）. Conclusion BIPAP is an effective ventilation pattern for patients with acute exacerbations of chronic obstructive pulmonary disease complicated with serious hypereapnia. Correct application of BIPAP in the patients suffered from hypercapnia can decrease the fatality rate, and shorten the average duration of hospitalization. Therefore, BiPAP is an effective therapy for hypereapnia.