BiPAP呼吸机辅助通气对老年AECOPD患者合并呼吸衰竭的疗效观察

Clinical Observation of BiPAP Ventilator-assisted Ventilation in Elderly AECOPD Patients with Respiratory Failure

目的探讨BiPAP辅助通气对慢性阻塞性肺疾病急性发作(AECOPD)合并呼吸衰竭的治疗效果。方法92例AECOPD合并呼吸衰竭患者随机分为两组,治疗组46例在常规治疗基础上,同时给于鼻(面)罩双水平气道正压(BiPAP)通气治疗,对照组46例给予常规治疗及鼻导管给氧,观察治疗前后患者血气分析的pH值、PaO2、PaCO2动态变化并比较两组间的差别。结果治疗后不同时间点2组的比较均有显著性差异(P<0.05);2组患者治疗后血气分析pH、PaO2、PaCO2的动态变化趋势具有显著性差异(P<0.001);治疗5d后,2组患者的Borg呼吸困难分级均明显下降(均P<0.001),但治疗组的Borg呼吸困难分级改善明显好于对照组(P<0.001)。结论BiPAP呼吸机可改变AECOPD合并呼吸衰竭的短期血气变化及短期预后。

Objective To explore the therapeutic effect of BiPAP ventilation to AECOPD patients combined with respiratory failure. Methods Total 92 eases of acute exacerbation chronic obstructive pulmonary disease （AECOPD） patients with respiratory failure were divided into two groups randomly. On the basis of conventional treatment, the 46 cases of treatment group were given to the nasal （facial） mask bi - level positive airway pressure （ BiPAP ） ventilation treatment at the same time, while the 46 cases of the control group were given conventional treatment and nasal oxygen inhalation. The dynamic variation of pH value, PaO2 and PaCO2 of blood gas analysis were observed and the difference between the two groups were compared before and after treatment. Results The comparison were significantly different （P 〈 0.05 ） between 2 groups on different time points after treatment; The dynamic change in patients of 2 groups after treatment were trend of pH value, PaO2 and PaCO2 of blood gas analysis significant different （P 〈 0. 001 ） ; After the treatment of 5d the Borg dyspnea grade of 2 groups of patients were significantly decreased （all P 〈 0. 001 ） , but the treatment group was better than that of the control group （P 〈 0. 001 ）. Conclusion BiPAP breathing machine can improve blood gas changes and prognosis in AECOPD patients with respiratory failure in short-term.