BiPAP无创通气治疗老年慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的临床疗效观察

The observation of clinical efficacy of BiPAP non-invasive mechanical ventilation treatment on elderly COPD combined with respiratory failure type Ⅱ

目的评价双水平无创正压通气(BiPAP)治疗老年慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效。方法87例60岁以上COPD合并Ⅱ型呼吸衰竭患者,分为治疗组41例和对照组46例,两组均给予常规药物治疗,治疗组同时给予BiPAP无创通气治疗。结果BiPAP耐受良好的26例患者,治疗后其动脉血氧分压(PaO2)和二氧化碳分压(PaCO2)较治疗前明显改善(P<0.01);与对照组比较,平均住院天数缩短(P<0.05)、血气改善时间提前(P<0.01)、血气改善程度更好(P<0.05);BiPAP治疗还可以减慢呼吸频率和心率(P<0.01),而对患者血压水平无明显影响(P>0.05);且无1例发生腹胀、面部皮肤压伤、气压伤或呼吸机相关肺炎。结论经鼻罩BiPAP无创通气是治疗老年COPD合并Ⅱ型呼吸衰竭的一种安全有效的方法。

Objective To evaluate the clinical efficacy of non-invasive mechanical ventilation on chronic obstructive pulmonary disease （COPD） combined with respiratory failure type Ⅱ by hi-positive airway pressure （BiPAP） breathing machine. Methoils 87 patients older than 60 years who suffered from COPD combined with respiratory failure type lI were enrolled and divided into treatment group （41 cases） and control group （46 cases）. Routine pharmaceutical intervention was adopted in both groups while noninvasive mechanical ventilation by BiPAP breathing machine was given in the patients of treatment group. Results In 26 patients welltolerated with BiPAP breathing machine ,arterial partial pressure of oxygen and carbon dioxide were significantly improved after treatment. Comparing with control group, mean hospitalization day was shortened, and blood gas improvement were earlier and better. BiPAP treatment slowed down the frequency of respiratory and heart rate with no influence on patients blood pressure. No abdominal distention,skin crush,wind-contusion and ventilator-associated pneumonia was complicated. Conclusions Non-invasive mechanical ventilation via face mask by BiPAP breathing machine is efficient and safe on COPD combined with respiratory failure type Ⅱ.