无创正压通气治疗COPD并慢性呼吸衰竭疗效观察

Efficacy of Noninvasive Positive Pressure Ventilation for Chronic Obstructive Pulmonary Disease with Respiratory Failure

目的探讨无创正压通气治疗慢性阻塞性肺疾病(COPD)并发慢性呼吸衰竭患者的疗效。方法对住院8例稳定期COPD并发慢性呼吸衰竭患者采用BiPAP呼吸机经鼻/面罩无创正压通气治疗,4h/次,2次/d,连续2个月。治疗前后对动脉血气及肺通气功能进行检测,并进行统计学分析。结果动脉血气治疗前后PaCO2分别为(61.837±18.214)mmHg和(40.013±1.768)mmHg,PaO2分别为(44.125±11.679)mmHg和(76.000±9.970)mmHg、SaO2分别为(72.125±12.789)%和(91.750±3.410)%,差异有统计学意义(P<0.05);肺功能治疗前后FEV1分别为(18.00±4.36)%和(34.67±8.96)%、FEV1/FVC分别为(43.67±2.52)%和(55.00±4.58)%,差异有统计学意义(P<0.05)。结论无创正压通气治疗缓解期COPD呼吸衰竭患者可改善肺通气功能,改善患者缺氧情况及降低动脉血气CO2潴留,是一个值得推荐的治疗方法。

Objective To explore the therapeutic effects of noninvasive positive pressure ventilation （NPPV） for chronic obstructive pulmonary disease（COPD） combined with respiratory failure. Methods Eight patients with stable COPD and respiratory failure underwent bi-level positive airway pressure（Bi-PAP） by nasal or facial mask. The arterial blood gases analysis and pulmonary ventilation functions were observed before the treatment and two months after the treatment. Results The difference of PaCO2 （61. 837 ± 18.214 vs 40.013 ±1. 768 mm Hg）, PaO2 （44.125 ±11. 679 vs 76.000 ±9. 970 ） and SaO2 （ % ） （72.125 ±12.789 vs 91. 750 ± 3. 410 ） were significantly（ P 〈 0.05 ） before and after the treatment. There were also significant difference in the pulmonary functions of FEVI ： （ 18. 00 ± 4.36 vs 34.67± 8.96 ）, FEV1/FVC ： （ 43.67 ± 2.52 vs 55.00 ± 4.58 ） before and after the treatment （ P 〈 0.05 ）. Conclusion NPPV can improve the pulmonary ventilation function and hypoxic, decrease the plasma level of carbon dioxide（ CO2 ） in patients with stable COPD and respiratory failure. pressure ventilation; Respiratory failure