无创正压通气治疗慢性阻塞性肺疾病急性加重期伴Ⅱ型呼吸衰竭65例

No-invasive positive pressure pentilation for chronic obstructive pulmonary disease at acute exacerbation period complicating respiratory failure of type Ⅱ of sixty five patients

目的探讨无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)急性加重期合并Ⅱ型呼吸衰竭患者的疗效。方法选择COPD急性加重期伴有Ⅱ型呼吸衰竭患者127例,分为观察组65例和对照组62例,对照组以药物治疗为主,观察组以NIPPV加药物治疗。观察2组治疗前后呼吸频率和心率,收集治疗前和治疗后3 h、1、3、7 d动脉血气分析结果,并进行比较。结果治疗前2组呼吸频率、心率比较差别无统计学意义(P>0.05)。治疗后2组呼吸频率、心率较同组治疗前均有所改善,治疗1、3、7 d时与治疗前比较差别有统计学意义(P<0.05)。治疗3、7 d时2组呼吸频率、心率比较差别有统计学意义(P<0.05)。治疗前2组pH、PaO2及PaCO2比较差别无统计学意义(P>0.05);2组治疗3 h、1、3、7 d时pH、PaO2及PaCO2较治疗前有改善,差别均有统计学意义(P<0.05);治疗1、3 d时2组pH比较差别有统计学意义(P<0.05);治疗3 h、1、3、7 d时2组PaO2、PaCO2比较差别有统计学意义(P<0.05)。结论 NIPPV治疗COPD急性加重期合并呼吸衰竭疗效确切。

Objective To evaluate the clinical effect of no-invasive positive-pressure ventilation（NIPPV） in treating chronic obstructive pulmonary diseases（COPD） at acute exacerbation period complicating type Ⅱ respiratory failure.Methods One hundred and twenty-seven cases with COPD at acute exacerbation period complicating type Ⅱ respiratory failure were divided into observation group（n=65） and control group（n=62）.The control group were given drug treatment;Based on this,NIPPV were given in observation group.The breathing frequency and heart rate before and after treatment were observed between two groups.The arterial blood gas analysis results were collected before and 3 hours,1,3,7 days after the treatment and then were compared between two groups.Results There were no statistic significance of heart rate and breathing frequency before treatment between two groups（P〉0.05）.Compared with before treatment,the heart rate and breathing frequency in the two groups were improved significantly at 3 hours,1,3,7 days after treatment（P〈0.05）.There were statistical significance of heart rate and breathing frequency at 3,7 days after treatment between two groups（P〈0.05）.Before treatment the difference of pH,PaO2 and PaCO2 had no statistical difference between two groups（P〉0.05）.At 3 hours,1,3,7 days after treatment,the pH,PaO2 and PaCO2 were significant improved,and the difference made statistical difference（P〈0.05）.At 1 day and 3 days after treatment the pH was statistically significant difference between two groups（P〈0.05）.At 3 hours,1,3,7 days after treatment the PaO2 and PaCO2 was statistic significance between two groups（P〈0.05）.Conclusion NIPPV has great effects to treat COPD at acute exacerbation complicating type Ⅱ respiratory failure.