BiPAP无创通气治疗慢性肺心病合并Ⅱ型呼吸衰竭的临床观察

Effect of bilevel positive airway pressure ventilation on chronic pulmonary heart disease complicated by type Ⅱ respiratory failure

目的探讨BiPAP无创呼吸通气治疗慢性肺心病合并Ⅱ型呼吸衰竭的临床疗效。方法将68例慢性肺心病合并Ⅱ型呼吸衰竭的住院患者随机分为两组,对照组(n=34)予以常规综合治疗,治疗组(n=34)在常规综合治疗的基础上加用BiPAP无创呼吸通气治疗,3d后对两组患者的血气分析、心率、呼吸频率及临床症状等进行比较,并统计患者住院天数及病死率。结果无创通气干预3d后,治疗组血SaO2、pH值、PaO2、PaCO2分别为94.3%、7.36、82.1mmHg、49.6mmHg,其改善程度明显优于对照组(89.0%、7.31、72.8mmHg、58.9mmHg),P<0.05。治疗组住院天数(13d)及病死率(2.9%)明显短于或低于对照组(分别为21d和11.8%),P<0.01。结论无创通气治疗,能有效改善患者血气分析指标及临床症状,提高救治成功率,缩短住院时间。

Objective To investigate the effect of bilevel positive airway pressure（BiPAP） ventilation on chronic pulmonary heart disease complicated by typeⅡrespiratory failure.Methods Sixty-eight patients with pulmonary heart disease complicated by typeⅡrespiratory failure were divided into control group and treatment group（n=34）.Patients in control group were given conventional general treatment only while patients in treatment group were given BiPAP ventilation besides conventional treatment.Three days later,respiratory rate（RR）,heart rate（HR）,SaO2,pH,PaO2,and PaCO2 of patients in the two groups were compared,and their hospitalized time（days） and mortality were recorded.Results Three days after intervention,the SaO2,pH,PaO2,and PaCO2 of the patients in treatment group were 94.3%,7.36,82.1mmHg,and 49.6mmHg,respectively,which were significantly higher than those（89.0%,7.31,72.8mmHg and 58.9mmHg） of the patients in control group.The hospitalized time（13 days） and mortality（2.9%） of the patients in treatment group were shorter and lower than those（21 days and 11.8%） of the patients in control group.Conclusion BiPAP ventilation is of effects on chronic pulmonary heart disease complicated by typeⅡrespiratory failure.