无创正压通气治疗AECOPD合并Ⅱ型呼衰失败原因分析

Analysis of failure reason of non-invasive positive pressure ventilation on AECOPD with type Ⅱ respiratory failure

目的分析在慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭患者中使用无创通气的失败原因。方法通过对本院2006年9月～2009年1月住院的无创辅助通气失败的34例进行回顾性分析。结果无创通气治疗34例失败病例中;低氧血症和高碳酸血症不能纠正或恶化共16例占47%,不耐受而拒绝继续治疗8例占23%,胃肠胀气5例占15%,面罩漏气3例占9%面部皮肤破损而无法使用面罩2例占6%。结论掌握好无创通气的适应证和禁忌证及通气过程中加强观察和监测是提高无创通气技术成功率的关键。

Objective To analyze the failure reason of non-invasive positive pressure ventilation on AECOPD with type Ⅱ respiratory failure. Methods The materials of 34 patients hospitalized with unsucessful non-invasive positive pressure ventilation from September 2006 to January 2009 were analyzed retrospectively. Results Among the failure reasons of the cases, the 47% reported was un-redressed hyoxemia and hypercapnemia, 23 % was intolerance and rejection to mechanical ventilation, 15% was flatulence, 9% was mask leakage, 6% was facial skin breakage. Conclusion The master on indication and contraindication of non-invasive ventilation and the elaborative observation and monitoring is key to improve the rate of effectiveness of non - invasive ventilation.