慢性阻塞性肺疾病急性加重期无创正压通气治疗的临床观察

Chronic Obstructive Pulmonary Disease with Acute Exacerbation of Noninvasive Positive Pressure Ventilation in Treatment of Clinical Observation

目的:探讨无创正压通气(NIPPV)治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭的疗效。方法:70例AECOPD合并Ⅱ型呼吸衰竭患者随机分为对照组和试验组。在常规治疗的基础上,对照组予低流量吸氧(2L/min),试验组接受呼吸机无创通气治疗。于治疗前、治疗后5天,分别记录动脉血气指标(pH、PaCO2、PaO2)、肺功能(FEV1/FVC%、RV/TLC%、DLCO%)。结果:两组患者在治疗前在年龄、病程、血气分析及肺功能等方面无明显差异。两组患者治疗前后动脉血气检测及肺功能(RV/TLC%、DLCO%)结果及治疗后组间比较差异有显著性(P<0.05),但两组肺功能FEV1/FVC%治疗前后及组间比较无显著性差异,两组插管率比较差异有显著性(P<0.05)。结论:无创通气是治疗慢性阻塞性肺疾病急性加重期并发Ⅱ型呼吸衰竭的一种有效方法。早期使用能阻止病情的发展,缓解临床症状,降低气管插管率。

Objective：Noninvasive positive pressure ventilation （NIPPV） treatment of chronic obstructive pulmonary disease with acute exacerbation （AECOPD） with respiratory failure patients. Methods：70 cases of AECOPD with type Ⅱ respiratory failure were randomly divided into control group and experimental group. In the conventional treatment on the basis of the control group to the low-flow oxygen （2L/min）,test group received ventilator treatment of non-invasive ventilation. In the pre-treatment,five days after treatment,arterial blood gases were recorded indicators （pH,PaCO2,PaO2）,lung function （FEV1/FVC%,RV/TLC%,DLCO%）. Results：The two groups of patients before treatment in age,disease,blood gas analysis and pulmonary function and so no significant difference. Two groups of patients before and after the detection of arterial blood gases and lung function （RV/TLC%,DLCO%） results and the comparison group after treatment there was a significant difference （P0.05）,but the two groups before and after treatment in lung function and FEV1/FVC% group comparison no significant differences in intubation rates were significantly different （P0.05）. Conclusion：The non-invasive ventilation is the treatment of chronic obstructive pulmonary disease complicated by acute exacerbation of respiratory failure type Ⅱ an effective method. Early use can prevent the development of the disease and ease symptoms,reduce the rate of endotracheal intubation.