双水平气道内正压通气治疗慢性阻塞性肺疾病合并肺性脑病的临床应用

The Clinical Practice of the Therapy of Bi-level Positive Airway Pressure (BiPAP) in Pulmonary Encephalopathy Induced by COPD

目的观察双水平气道内正压通气(BiPAP)治疗慢性阻塞性肺疾病(COPD)合并肺性脑病的有效性和安全性。方法对42例COPD合并肺性脑病的患者在常规药物治疗的基础上,加用BiPAP呼吸机治疗,监测通气前后患者神志变化,动脉血气;并回顾分析使用呼吸兴奋剂患者进行组间对照,比较两组的神志恢复时间、住院天数及预后。结果BiPAP组除有3例因病重死亡外,其余53例患者的神志恢复时间、动脉血二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)、呼吸频率(RR)、心率(HR)变化较通气前明显改善(P<0.01),神志恢复时间、住院天数、病死率较呼吸兴奋剂组减少。结论双水平气道内正压通气对COPD合并肺性脑病的疗效确切,可作为临床一线治疗方法。

Objective： To decide the efficiency and safety of the therapy of Bi-level positive airway pressure （BiPAP） in pulmonary encephalopathy induced by COPD. Methods： Fifty-six patients applied with BiPAP and 33 patients treated with respiratory stimulants were reviewed. Arterial blood gas, the time of recovery of mind and mortality were compared. Results： There were 3 patients died in BiPAP-treated group while 7 in another group. Except of these died patients, the patients treated with BiPAP were recovered much more quickly, such as mind, the level of PaCO2, PaO2, the time of hospitalization. Conclusion： BiPAP is a useful therapy in the treatment of pulmonary encephalopathy induced by COPD.