无创正压通气救治慢性阻塞性肺疾病并重度呼吸衰竭疗效观察及体会

Clinical assess the efficacy of noninvasive positive pressure ventilation in the treatment of COPD combined with aggravated respiratory failure

目的:评价无创正压机械通气在救治慢性阻塞性肺疾病(COPD)合并严重呼吸衰竭中的作用。方法:观察30例COPD急性加重并严重呼吸衰竭患者,在常规药物治疗基础上给予经鼻或口鼻面罩无创正压通气(NIPPV),分别于通气前、通气后2h、24h及48h血气分析测定,并观察病情变化。结果:NIPPV治疗后PaCO_2明显下降, PaO_2、PH值上升,30例患者中25例通气2h后症状开始明显缓解,意识逐渐转清,有效率为83.3%,3例因病情加重改气管插管,2例用NIPPV通气前已合并多器官衰竭,在通气治疗中死亡。结论:无创正压通气是COPD合并重症呼吸衰竭抢救的一种有效措施。

Objective： To assess the clinical the efficacy of noninvasive positive pressure ventilation in the treatment for exacerbation phase combined with aggravated respiratory failure. Methods：Thirty patients of COPD combined with aggravated respiratory failure were treated with NIPPV, as well as conventional therapeutic managements. Compare patient blood gas results before and after therapy in 2h, 24h, and 48h, respective. Results：After 2 hours, 25 of the 30 patients （83.3%） using NIPPV have significantly changed in blood gas after therapy （P〈0.05 ） in pH value, PaCO2, PaO2 and consciousness recovered gradu^ly. Five patients were died during NIPPV, including three patients have enforced tracheal intubation because of aggravating and two patients developed multiple organ failure before using NIPPV. Conclusion： NIPPV is an effectual therapeutic management for COPD combined with aggravated respiratory failure.