BiPAP无创通气治疗COPD并发Ⅱ型呼吸衰竭

Clinical efficacy of non-invasive,BiPAP ventilation on COPD combined with type Ⅱ respiratory failure

目的：探讨双水平气道正压（BiPAP）无创通气对慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）并发Ⅱ型呼吸衰竭（呼衰）的疗效。方法：57例COPD患者随机分为对照组28例和治疗组29例。两组均予抗感染、平喘等常规治疗,治疗组加用BiPAP呼吸机无创正压通气（NPPV）治疗。测定两组治疗前及治疗后24 h、48 h的心率、呼吸频率及动脉血气。结果：治疗组治疗后各时段各指标与治疗前24 h、48 h比较均有统计学意义（P〈0.01）。两组治疗后各时段心率及动脉血气比较,差异均有统计学意义（P〈0.05-P〈0.01）,而呼吸频率无差异（P〉0.05）。治疗组未发现严重并发症。结论：NPPV对COPD并发Ⅱ型呼衰有显著的治疗作用,具有良好的临床实用价值。

Objective： To evaluate the clinical effect of non invasive, binary level positive airway pressure （BiPAP） ventilation respirator in treatment of chronic obstructive pulmonary disease （COPD） accompanied by type Ⅱ respiratory failure. Methods： Fiftyseven cases of COPD were randomly divided into two groups （28 cases in control group and 29 cases in treatment group）. The control group were treated with routine therapy only and the treatment group received non-invasive positive pressure ventilation （NPPV） with BiPAP ventilator in addition to the routine therapy. The heart rate （HR） ,respiratory rate （RR） and parameters of gas exchange were measured in each group at the time of enrollment （0 hour） ,24 hours and 48 hours after treatment. Results：Compared with the control group ,the HR, RR and arterial blood gas in the treatment group were significantly improved after ventilation for 24 h and 48 h. The difference was significant （P 〈 0. O1 ）. After the therapy, the foregoing parameters in the treatment group were superior to the control group （P 〈0.05 -P 〈 0.01 ） and no obvious side effect was observed. Conclusions： NPPV has a remarkable healing effect on chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure and has great practical value in clinical application.