无创正压通气在慢性阻塞性肺疾病急性加重期治疗中的应用

Non-invasive Positive Pressure Ventilation for Treating the Chronic Obstructive Pulmonary Diseases with Acute Exacerbation

目的：探讨无创正压通气在慢性阻塞性肺疾病（COPD）急性加重期的治疗作用。方法：48例COPD急性加重期患者随机分为两组。对照组22例行常规治疗；治疗组26例除常规治疗外，同时采用双水平无创正压通气（BiPAP）治疗。结果：治疗组无创正压通气治疗3h、24h的动脉血气分析示，PH、PaCO2及PaO2值较治疗前有明显改善（P〈0．05）。治疗组住院时间较对照组短（P〈0．05），治愈率较对照组高（P〈0．05），气管插管率和住院死亡率较对照组低。结论：使用BiPAP呼吸机行无创正压通气，其方法简便、有效、并发症少，对COPD急性加重期患者早期应用，可缩短患者住院时间、降低死亡率、提高痊愈率。

Objective：To investigate the therapeutic effect of non-invasive positive pressure ventilation （NIPPV） on the chronic obstructive pulmonary disease （COPD） in acute exacerbation. Methods：Forty eight cases of COPD with acute exacerbation were randomly divided into control group （n =22） and treatment group （ n = 26）, which were treated by conventional therapy alone and conventional therapy combined with NIPPV, respectively. Results：The arterial blood gas analysis on the patients in the treatment group showed that, at the third and 24th hour after the treatment, the levels of power of hydrogen （PH）, partial pressure of carbon dioxide in artery （ PaCO2 ） and arterial oxygen tension （ PaO2 ） got obvious improvement （ P 〈 0.05 ）. Compared with the control group, the mean length of patient stay in the treatment group was shorter （ P 〈 0.05 ）, and the cure rate was higher（P 〈 0.05 ）, the frequency of tracheal intubation and the hospital mortality were lower. Conclusions：The NIPPV is convenient, effective and safe for treating the COPD with acute exacerbations. Employing the NIPPV as possible as on the patients with COPD could shorten the length of patient stay, decrease the death rate and enhance the rate of healing well.