无创正压通气治疗慢性阻塞性肺疾病合并2型呼吸衰竭75例临床观察

Clinical therapeutic effect of non-invasive positive pressure ventilation upon COPD combined with type 2 respiratory failure

目的观察无创通气在治疗COPD合并2型呼吸衰竭患者中的临床疗效。方法选择147例COPD合并2型呼吸衰竭患者随机分为治疗组75例和对照组72例,两组均给予常规抗感染、解痉、吸氧等常规治疗,治疗组在常规治疗的基础上进行NIPPV治疗,对照组仅给予常规治疗,观察血气指标、心率、血压、呼吸频率的变化。结果治疗组和对照组在治疗后动脉血气pH值、PaCO2、PaO2、心率和呼吸频率与治疗前比较均有明显改善(P<0.05)。治疗组在降低PaCO2、呼吸频率和提高PaO2方面比对照组更明显(P<0.05)。结论NIPPV治疗COPD合并2型呼吸衰竭效果明显,值得临床应用。

Objective To observe the clinical effect of non-invasive positive pressure ventilation （IPPV） in the treatment of chronic obstructive pulmonary disease combined with type 2 respiratory failure. Methods 75 patients of therapeutic group were treated with NIPPV, as well as conventional therapeutic managements, such as antibiotic, pacifying gasp, eliminating phlegm, taking respiratory stimulants, and receiving continual low-flow oxygen. Whereas, 72 controls only received conventional intervention. The blood gas indices, heart rate （HR）. blood pressure （Bp） and respiratory rate （RR） were recorded. Results There was no significant difference between the two groups in the above parameters before the treatment, but pH value, PaCO2, PaO2, HR and RR were ameliorated in the two groups after treatment; the therapeutic group showed significant improvement in PaCO2, RR and PaO2 more than the control group. Conclusion NIPPV intervention is effective to treat COPD combined with type 2 respiratory failure, and deserves further clinical application.