双水平无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的临床研究

Clinic Observe of Non-invasive Bi-Level Positive Airway Pressure in Treatment for Chronic Obstructive Pulmonary Disease Combined with Type Ⅱ Respiratory Failure

目的探讨无创通气在慢性阻塞性肺疾病并Ⅱ型呼吸衰竭中的应用价值。方法将46例慢性阻塞性肺疾病(COPD)呼吸衰竭患者随机分为两组,对照组21例给予常规治疗,治疗组25例在常规治疗基础上,同时给予鼻(面)罩双水平气道正压(BiPAP)通气治疗,观察治疗前后患者的意识、呼吸、心率、pH、PaO2、PaCO2。结果治疗后两组临床症状、血气分析指标均有显著变化,而治疗组各项指标改善程度更优于对照组(P均<0.05)。结论无创正压通气是治疗COPD合并Ⅱ型呼吸衰竭的有效手段,配合相应护理措施,可使患者避免气管插管,降低病死率,提高生活质量。

Objective To explore the application of non-invasive ventilation in chronic obstructive pulmonary disease（COPD） combined with respiratory failure.Methods 46 cases of chronic obstructive pulmonary disease（COPD） combined with respiratory failure were randomly divided into two groups：control group（n=21） with routine medication and experiment group（n=25）,with nose and face mask of bi-level positive airway pressure based on routine medication,to observe the patient′s consciousness,breath,heart rate,Ph,PaO2,PaCO2 before and after the treatment.Results After treantments,the clinical symptom,blood gas analysis of these two groups are noticeable changes.And all the index of experiment group are more improvement than control group（P0.05）.Conclusion Non-invasive positive airway pressure is utility method in treatment of COPD combined with typeⅡ respiratory failure,together with relative nursing intervention,to avoid tracheal intubation,to lower case fatality and improve quality of life.