无创正压通气治疗慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭的临床观察

Clinical Observation of Non-Invasive Positive Pressure Ventilation in Treatment of Chronic Obstructive Pulmonary Disease Combined with Type Ⅱ Respiratory Failure at Acute Exacerbation Phase

目的观察无创正压通气(NIPPV)在治疗慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭患者中的临床疗效。方法将88例慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭的患者随机分为2组。对照组46例,给予常规抗感染、解痉、平喘、止咳、化痰、吸氧、呼吸兴奋剂治疗等处理;治疗组42例,在上述治疗基础上加用无创正压通气治疗。比较治疗开始后2h、24h、72h两组同期血气、血压、心率、呼吸频率等改善情况。结果治疗组同期血气、血压、心率、呼吸频率等较对照组明显改善(P均<0.05)。结论使用无创正压通气(NIPPV)可明显改善慢性阻塞性肺病急性加重期合并Ⅱ型呼吸衰竭患者的血气及临床症状,是一种有效的治疗手段。

Objective To observe the clinical effect of non-invasive positive pressure ventilation（NIPPV） in the treatment of chronic abstractive pulmonary disease（CAPD） combined with Type Ⅱ respiratory failure at acute exacerbation phase. Methods 88 patients with CAPD combined with Type Ⅱ respiratory failure at acute exacerbation phase were randomly divided into two group. 46 patients in control group were treated with conventional therapy such as antibiotic, pacifying gasp, relieving cough, resolving phlegm, respiratory stimulant and continual low-flow oxygen etc. 42 patients in therapeutic group with NIPPV based on above treatments. The blood gas analysis index,blood pressure,heart rate and breath rate were measured between both groups at 2 h,24 h,and 72 h after treatment. Results Compared with the result of control group, the blood gas analysis index, blood pressure, heart rate and breath rate were improved significantly in therapeutic group（ P 〈 0.05 ）. Conclusions NIPPV can effectively improve the blood gas analysis index and clinical symptoms of CAPD combined with Type Ⅱ respiratory failure at acute exacerbation phase.