无创呼吸机治疗慢性阻塞性肺病并发Ⅱ型呼吸衰竭76例临床分析

Clinical analysis of non-invasive positive pressure ventilator in treatment of chronic obstructive pulmonary disease with typeⅡ respiratory failure

目的探讨鼻面罩双水平气道正压通气(BiPAP)治疗慢性阻塞性肺病(COPD)并发Ⅱ型呼吸衰竭的治疗作用。方法 76例COPD急性加重期并发Ⅱ型呼吸衰竭患者应用BiPAP呼吸机辅助通气治疗,通过自身对照观察患者治疗前、后血气指标和病情改善程度。结果经BiPAP呼吸机治疗无创呼吸机通气3 d后66例患者与治疗前比较动脉血氧分压(PaO2)明显升高,动脉血二氧化碳分压(PaCO2)明显降低,pH、心率、呼吸频率明显改善,差异有统计学意义(P<0.01)。结论应用BiPAP呼吸机辅助治疗COPD合并呼吸衰竭可提高PaO2,降低PaCO2,改善通气,值得临床推广应用。

Objective To investigate the therapeutical effect of the（nasal）mask bi-level positive airway pressure（BiPAP）ventilator in the treatment of chronic obstructive pulmonary disease（COPD）with type Ⅱrespiratory failure.Methods 76 patients with acute exacerbation of COPD combined with type Ⅱ respiratory failure were treated with BiPAP ventilator-assisted ventilation therapy.The changes of arterial gas analysis and physiological indexes before and after the treatment were evaluated.Results Among 76 patients,PaO_2 significantly increased and PaCO_2 significantly decreased,with pH,heart rate,respiratory rate significantly improved in 66 cases 3 days after the treatment（P〈0.01）.Conclusion BiPAP ventilator-assisted ventilation in the treatment of COPD combined with respiratory failure can improve PaO_2,lower PaCO_2,and improve ventilation.It is useful to be applied in clinical treatment.