无创正压通气治疗AECOPD合并呼吸衰竭的疗效观察

Clinical analysis of non-invasive positive pressure ventilation for chronic obstructive pulmonary disease complicated with respiratory failure

目的探讨无创正压通气(NIPPV)治疗慢性阻塞性肺病急性加重期(AECOPD)合并呼吸衰竭的临床效果。方法观察26例NIPPV治疗AECOPD合并呼吸衰竭患者的血气指标变化(PH、PaO2、PaCO2),住院病程,气管插管率和病死率,并同以往未使用NIPPV治疗30例AECOPD合并呼吸衰竭病例进行比较。结果26例NIPPV治疗后2h、48h血气指标明显改善,住院病程缩短,气管插管率和病死率明显降低,同非NIPPV治疗的对照组比较差异有显著性。结论NIPPV是治疗AECOPD合并呼吸衰竭的一种有效方法,早期应用可阻止病情进一步加重,避免有创机械通气,缩短病程。

Objective To review and summarize the therapeutic effect of non-invasive positive pressure ventilation （NIPPV） in treating chronic obstructive pulmonary disease （COPD） complicated with respiratory failure and to analyze correlative factors that affect therapeutic effect.Methods 26 cases with acute exacerbations of COPD complicated with respiratory failure were treated with NIPPV,30 cases were subjected to conventional therapy （control group）.Results Arterial blood gas indexes were significantly improved after the treatment in 26 patients well-tolerated with BiPAP treatment.Compared with the control group,mean hospital stay shortened,the timing of blood gas and the mortality both reduced.1 case in NIPPV group （14% failure rate） subsequently required intubation and mechanical ventilation.Conclusion NIPPV via face mask by BiPAP is an efficient and safe treatment on COPD combined with respiratory failure type Ⅱ.