无创正压通气治疗AECOPD呼吸衰竭伴意识障碍的临床观察

Clinical observation of non-invasive positive pressure ventilation in treatment of AECOPD and respiratory failure with conscious disturbances

目的探讨无创正压通气(NIPPV)在救治慢性阻塞性肺疾病急性加重期(AECOPD)并严重呼吸衰竭伴意识障碍患者的疗效。方法对入选的30例AECOPD并严重呼吸衰竭伴意识障碍患者使用双水平无创正压呼吸机面罩辅助通气,动态观察NIPPV治疗前和治疗后2 h、24 h患者的意识、呼吸、心率及动脉血气中pH、PaCO2、PaO2的变化以及治疗后的转归,NIPPV的不良反应及并发症。结果本组30例中26例经NIPPV治疗后患者的呼吸频率(RR)、心率(HR)、动脉血pH、PaO2、PaCO2及意识状态均较治疗前明显改善(P<0.01),有效率为86.67%(26/30)。结论双水平无创正压通气对有选择的AECOPD并重度呼吸衰竭伴意识障碍患者疗效确切。

Objective To investigate the efficacy of non-invasive positive pressure ventilation（NIPPV） in the treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） and severe respiratory failure with conscious disturbances.Methods Thirty patients with AECOPD and severe respiratory failure complicated with conscious disturbances were enrolled.The subjects received assisted ventilation via facial mask by bi-level NIPPV.The clincal indexes,arterial blood gas parameters and conscious state,outcome and complications were observed before and after treatment.Results After treatment,the subjects had siginicant improvement in HR,RR,PH,PaO2 PaCO2 and conscious states（P0.01）.Effectiveness of the treatment was 86.67%（26/30）.Conclusion Bi-level non-invasive positive ventilation is an effective therapy for the patients with AECOPD and severe respiratory failure with conscious disturbances.