无创双水平气道正压通气治疗特发性肺纤维化并呼吸衰竭

Noninvasive Bi-level positive airway pressure ventilation in the treatment of respiratory failure by idiopathic pulmonary fibrosis

目的探讨无创双水平气道正压通气治疗特发性肺纤维化并呼吸衰竭的疗效。方法回顾23例经口鼻面罩双水平气道正压通气治疗特发性肺纤维化并呼吸衰竭的患者,分析比较治疗前后的临床症状、动脉血气分析变化,观察治疗的副反应。结果23例中19例临床症状明显好转,治疗有效率达82.6%,BiPAP呼吸机治疗后2h及治疗后2周PaO2、SaO2及PaCO2均持续有显著提高,生活质量改善。主要副反应为口咽干燥、胃胀气等。结论无创双水平气道正压通气可缓解特发性肺纤维化所致的呼吸衰竭,改善临床症状,提高生活质量,副反应少,使用方便。但长期疗效有待进一步观察。晚期患者不能改善预后。

Objective To investigate the clinical efficacy of noninvasive bi-level positive airway pressure （BiPAP） ventilation in the treatment of respiratory failure caused by idiopathic pulmonary fibrosis （IPF）. Methods Twenty-three cases of respiratory failure caused by IPF were treated with BiPAP. Study and comparison were done with respect to the clinical symptoms, alteration of arterial blood gas and side effects. Results 19 of 23 patients clinical symptoms significantly improved, the remission rate of BiPAP was 82. 6%. PaO2 ,SaO2 and PaCO2 were significantly enhanced after BiPAP 2 hours and 2 weeks, the quality of llfe improved. The bloating and the dehydration of oropharynx were the main side effects. Conclusion The BiPAP is an effective remission for respiratory failure by IPF with improved clinical symptoms and quality of llfe, and less side effects. There is no effect for the patients with advanced stage. The long-term effect of BiPAP would be further observed.