无创呼吸机治疗慢性阻塞性肺疾病合并急性左心衰36例临床探讨

Clinical Analysis 36 Cases of Non-invasive Pressure Ventilater in Treatment of Chronic Obstructive Pulmonary Disease with Acute Left Heart Failure

目的探讨（鼻）面罩双水平气道正压通气（BiPAP）治疗慢性阻塞性肺痰病合并急性左心衰的治疗作用。方法36例COPD急性加重期合并急性左心衰的患者，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。结果经无创呼吸机通气2天后，33例患者与治疗前比较PaO：明显升高，PaC02明显降低，pH、心率、呼吸频率、氧和指数（Pao2／FiO2）、心衰症状明显改善，差异有统计学意义（P〈0．05）。结论应用BiPAP呼吸机辅助通气治疗COPD合并急性左心衰，可提高Pa02，降低PaC02，改善心衰症状，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 ofchronic obstructive pulmonary disease （COPD） with acute left heart failure. Methods 36 patients with acute exacerbation of COPD combined with acute left heart 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 36 patients,PaO2 significantly higher, PaCO2 significantly lower, and pH, heart rate, respiratory rate, PaOJFiO2, and symptom of heart failure significantly improved in 36 cases 2 days after the treatment （P〈O.05）. Conclusion BiPAP entilator-assisted ventilation in the treatment of COPD combined with zcute left heart failure can improve PaO2, lower PaC02, and improve symptom of heart failure, it is worthy to be popularized.