无创正压通气治疗老年AECOPD并Ⅱ型呼衰的疗效观察

Clinical study of noninvasive positive pressure ventilation in treating chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

目的探讨无创正压通气(NIPPV)在老年慢性阻塞性肺疾病急性加重期(AECOPD)并Ⅱ型呼吸衰竭中的应用价值。方法81例AECOPD合并Ⅱ型呼吸衰竭患者随机分为治疗组(43例)和对照组(38例),在接受常规药物治疗的同时,治疗组给予NIPPV治疗。比较两组血气、呼吸频率、心率、插管率、死亡率及住院时间。结果治疗组治疗24h后血气和呼吸频率、心率改善明显,差异有统计学意义(P<0.05),而对照组的改善时间在72h,治疗组插管率和住院时间均较对照组低,有统计学意义(P<0.05)。结论NIPPV可改善老年AECOPD并Ⅱ型呼吸衰竭患者的生命体征和血气,减少插管率和住院时间,是治疗老年AECOPD的有效手段。

Objective To investigate the application value of noninvasive positive pressure ventilation （NIPPV） in treating aged acute exacerbations of chronic obstructive pulmonary disease （AECOPD） with Type Ⅱ respiratory failure. Methods 81 cases of aged AECOPD with Type Ⅱ respiratory failure were randomly assigned into a treatment group （43 cases） and a control group （38 cases）. The control group was treated with standard therapy, and the treatment group was given standard therapy and immediate NIPPV mode. Compari- son was then made between the two groups for arterial blood gas, respiratory rate, heart rate, intubation rate, death rate, and period of hospitalization. Results At 24 hours post the treatment group showed improvement in blood gas analysis, respiratory rate, and heart rate comparing with the control group （ P 〈 0. 05 ）. The control group showed improvement at 72 hours. Intubation rate and period of hospitalization were lower in the treatment group than in the control group （ P 〈 0.05 ）. Conclusion NIPPV improves the vital signs and arterial blood gas of aged patients with AECOPD complicated by Type Ⅱ pulmonary failure. It decreases the intubation rate and period of hospitalization. Thus it is an effective method to treat aged AECOPD.