无创正压通气治疗慢性阻塞性肺疾病急性加重期并Ⅱ型呼吸衰竭的疗效观察

Non-invasive positive pressure ventilation treatment of acute exacerbations of chronic obstructive pulmonary disease and respiratory failure type Ⅱ of efficacy

目的:观察无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)急性加重期并Ⅱ型呼吸衰竭的疗效.方法:39例COPD急性加重期并Ⅱ型呼吸衰竭患者分为治疗组和对照组,比较两组入院时及入院后2,24,72h动脉血气分析结果、需气管插管的患者人数.结果:治疗组在应用NIPPV后2,24,72h血气分析中pH值、PaO2较入院时差异有统计学(P<0.05),PaCO2在72h较入院时差异有统计学意义(P<0.05).治疗组和对照组在治疗2h后的pH值、PaCO2差异无统计学意义,而PaO2有统计学差异(P<0.05);治疗组和对照组在治疗24,72h后pH值、PaO2,PaCO2差别均有统计学意义(P<0.05);治疗组插管率是5%,对照组插管率是26.3%,两者差异有统计学意义(P<0.05).结论:NIPPV治疗COPD急性加重期并Ⅱ型呼吸衰竭疗效肯定,不良反应较少.在掌握其适应证和禁忌证后可尽早使用NIPPV,以便使患者呼吸肌得到休息恢复,减少气管插管率,避免病情进一步加重.

AIM：To observe the non-invasive positive pressure ventilation （NIPPV） for chronic obstructive pulmonary disease （COPD） and acute exacerbation of type Ⅱ respiratory failure. METHODS：Thirty-nine patients with acute exacerbation of COPD and respiratory failure in patients with type Ⅱ were divided into treatment and control groups were compared on admission and admission to hospital 2,24,72 h arterial blood gas analysis,the number of patients required endotracheal intubation. RESULTS：The treatment group in the application of NIPPV after 2, 24, 72 h in the PH value of blood gas analysis, PaO2 higher than at admission were signifieantly different （ P 〈 0.05 ） , PaCO2 on admission than in the 72 h differenee was significant （ P 〈 0.05 ）. The treatment group and control group after PH in the treatment of 2 h values, PaCO2 difference was not statistically significant, and PaO2 were significantly different （ P 〈 0.05 ） ; treatment group and control group in the treatment of 24, 72 h after the PH value, PaO2, PaCO2 difference was significant （ P 〈 0.05 ） ; treatment group intubation rate was 5% in the control group intubation rate was 26. 3%, the difference was significant （P 〈 0. 05）. CONCLUSION： NIPPV treatment of acute exacerbations of COPD and respiratory failure type Ⅱ sure, fewer adverse reaetions. The control of their indications and eontraindications as soon as possible after the use of NIPPV, in order to get to rest and recuperate in patients with respiratory muscle, reduce the rate of endotracheal intubation to prevent further aggravate the condition.