无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭

Effect of noninvasive positive pressure ventilation in patients of COPD combined with respiratory failure

目的观察无创正压通气(NPPV)在治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者中的临床疗效。方法治疗组42例AECOPD合并Ⅱ型呼吸衰竭患者在常规治疗的基础上进行NPPV治疗,对照组40例仅给予常规治疗(抗炎、解痉、吸氧等);观察血气指标、心率、血压、呼吸频率及住院时间的变化。结果治疗组和对照组在治疗后动脉血气pH值、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、心率和呼吸频率与治疗前比较均有明显改善。治疗组在降低PaCO2、呼吸频率和提高PaO2方面比对照组效果更明显。结论NPPV治疗AECOPD合并Ⅱ型呼吸衰竭能更有效地降低PaCO2、呼吸频率,提高PaO2,缩短住院时间。

Objective To observe the clinical effect of noninvasive positive pressure ventilation（NPPV）in the treatment of chronic obstructive pulmonary disease at acute exacerbation phase（AECOPD）combined with typeⅡrespiratory failure. Methods Forty-two patients of therapeutic group were treated with NIPPV,as well as conventional therapeutic managements,such as antibiotic,eliminating phlegm,spasmolysis,and receiving continual low-flow oxygen.Whereas,40 controls only received conventional intervention.Results There was no significant difference between the two groups before the treatment,but significance was found in pH value,PaCO2,PaO2,HR and RR after treatment.The therapeutic group showed significant improvement in PaCO2,RR and PaO2 compared with control group.Conclusion NPPV intervention can effectively decrease PaCO2 and RR,increase PaO2,and shorten the course of hospitalization.