BIPAP通气在AECOPD合并Ⅱ型呼吸衰竭的临床应用

Clinical Application of Bi-level positive Airway pressure Ventilation in Treatment of Chronic Obstructive Pulmonary Disease at acute exacerbation phase With Type-Ⅱ Respiratory Failure

目的探讨间歇使用BiPAP在治疗AECOPD合并Ⅱ型呼吸衰竭中的应用。方法对60例AECOPD合并Ⅱ型呼吸衰竭患者随机分为治疗组和对照组,各30例。对照组给予抗感染、平喘止咳祛痰、持续低流量吸氧及营养支持等治疗,治疗组在对照组治疗的基础上给予BiPAP通气治疗,观察两组治疗前后血气分析(pH、PaO2、PaCO2)变化。结果与对照组比较,Bi-PAP通气治疗4h后,PaO2升高、PaCO2降低;治疗24h后PaO2明显升高、PaCO2明显降低、pH值改善,两组差异均有统计学意义(P<0.05)。结论 BiPAP通气适用AECOPD合并Ⅱ型呼吸衰竭患者,可明显改善患者的低氧血症、高碳酸血症及pH值且治疗效果优于传统方法,值得临床推广应用。

Objective To discuss the application of bi-level positive airway pressure ventilation intermittently in treatment of chronic obstructive pulmonary disease at acute exacerbation phase with type-Ⅱ respiratory failure.MethodsSixty patients were randomized into two groups,one group receiwed conventional medical therapy（control group n=30）and the other group receiwed conventional therapy plus BiPAP ventilation（treatment group n=30）.The control group were giwen anti-infection,relieving asthma,eliminating phlegm,inhaling low wolume oxygen and supply treatment.The treatment group were treated with conventional edical therapy plus BiPAP wentilation.The parameters of arterial blood gas in two groups were recorded.ResultsThere were significant differences in PaO2 and PCO2 after 4 h in the treatment group than that in the control troup.After 24 h,PaO2,PCO2and pH changed significantly between the two groups（P0.05）.ConclusionBi-level positive airway pressure ventilation as auxiliary treatment is definitely valuable for AECOPD patients with type_Ⅱ chronic respiratory failure to improve hypoxemia and hypercapnia in comparison with conwentional medical therapy.