COPD伴Ⅱ型呼吸衰竭的无创机械通气治疗

Non-invasive mechanical ventilation treatment of COPD with type Ⅱ respiratory failure

目的探讨COPD伴Ⅱ型呼吸衰竭的无创机械通气治疗的临床疗效及动脉血气情况。方法 72例COPD合并呼吸衰竭患者随机分为治疗组和对照组,各36例。对照组采用常规治疗,治疗组在常规治疗基础上进行面罩双水平气道正压无创通气治疗,观察并比较两组患者的住院时间,及治疗前后(包括治疗前、治疗2、24、72h)动脉血气变化情况及临床疗效。结果两组患者的有效率比较,差异有统计学意义(χ2=7.26,P<0.05)。治疗组在予无创通气后2、24h及72h血气分析中,pH、PaO2均较入院时有明显改善(P<0.05),而PaCO2在4h有所下降,但差异无显著性,72h后PaCO2也有明显下降(P<0.05)。且两组患者住院时间的比较差异有统计学意义(P<0.05)。结论 COPD伴Ⅱ型呼吸衰竭的无创机械通气治疗的疗效是肯定的,值得临床推广和应用。

Objective To investigate clinical efficacy and arterial blood gas situation of COPD with the type Ⅱrespiratory failure which is treated with non-invasive mechanical ventilation.Methods 72 cases of COPD patients with respiratory failure were randomly divided into treatment group and control group（36 cases respectly）.Control group with conventional treatment,conventional therapy in the treatment group based on the mask bi-level positive airway pressure treatment of non-invasive ventilation,observe and compare the two groups of hospitalized patients,as well as before and after treatment （including pre-treatment,treatment of 2h,the treatment of 24h and 72h） changes in arterial blood gas and clinical efficacy.Results The efficiency of two groups of patients were compared,the difference was statistically significant （χ2=7.26,P0.05）.Treatment group to the non-invasive ventilation in after 2、24h and 72h of blood gas analysis,pH,PaO2 on admission were a significant improvement （P0.05）,and PaCO2 decreased in 4h,but the difference was not significant,72h after the PaCO2 also decreased significantly（P0.05）.Two groups of patients and length of stay of the more significant difference （P0.05）.Conclusion COPD with respiratory failure type Ⅱ non-invasive mechanical ventilation in the treatment of the effect is positive,worthy to be popularized and applied.