呼吸机治疗慢性阻塞性肺气肿并发急性呼吸衰竭

Treatment of Respiratory Failure Secondary to the Acute Exacerbation of COPD Through Pressure Ventilation Via Nasal/mouth Mask

目的:观察慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者应用B iPAP呼吸机正压通气治疗的效果。方法:45例COPD急性发作并Ⅱ型呼吸衰竭患者随机分为2组,治疗组23例采用B iPAP+常规治疗,对照组22例仅采用常规临床治疗,比较治疗前、治疗2h、24h后两组同期动脉血气及呼吸频率、心率改变。结果:治疗组PaO2、PaCO2、pH值较治疗前明显改善(P<0.05),改善与对照组比较,差异有显著性(P<0.05);呼吸频率、心率改变也较对照组明显(P<0.05)。气管插管发生率及平均住院天数均少于对照组(P<0.05)。结论:BiPAP是治疗慢性阻塞性肺气肿急性发作期并Ⅱ型呼吸衰竭经济、有效的方法。

Objective ：To evaluate the clinical effect by using bilevel positive airway pressure（BiPAP） ventilation via nasal/mouth mask in patients with respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary disease （COPD）. Method： 23 patients were randomly submitted either to standard therapy plus BiPAP and 22 patients to standard therapy. Cliniaal manifestation （ including respiratory rate, heart rate, blood pressure and conscious status） and arterial blood gas analysis before and after 2 hour, 24 hour after treatment in each group were comparatively analyzed. Result： After treatment by BiPAP, patients showed a significant improvement in PaO2 , PaCO2 , and clinical manifestation, and there was a sig- nificant difference between two groups （P 〈 0.05）. Conclusion： BiPAP ventilation is effective in patients with respiratory failure during acute exacerbation of COPD.