双水平正压通气治疗慢性阻塞性肺疾病呼衰的初步报告

The outcome of noninvasive positive pressure ventilation in treating chronic obstructive pulmonary disease complicated with respiratory failure

目的探讨双水平正压(BiPAP)模式行NIPPV在治疗慢性阻塞性肺疾病(COPD)呼吸衰竭的疗效。方法 70例COPD合并呼衰患者随机分为常规治疗组(A组,n=35),接受常规药物等治疗,NIPPV组(B组,n=35),在常规药物治疗的基础上应用面罩以双水平正压(BiPAP)模式行NIPPV。分析两组动脉血气结果、呼吸频率、心率、插管率、病死率及住院时间等观察指标。结果 NIPPV组2～3h及24h血气分析中的pH值、PCO2、PO2均较入院时改善且差异有统计学意义(P<0.05),而常规治疗组与入院时比较差异没有统计学意义(P>0.05);其中理论插管率NIPPV组)较常规治疗组低且差异有统计学意义(P<0.05);理论住院时间NIPPV组较常规治疗组短且差异有统计学意义(P<0.05)。结论双水平正压(BiPAP)模式行NIPPV可迅速改善COPD合并呼吸衰竭患者的血气情况,减少插管率与住院时间,是治疗呼衰的有效手段。

Objective To research the outcome of non-invasive positive pressure ventilation（NIPPV） in treating chronic obstructive pulmonary disease（COPD） complicated with respiratory failure. Methods Seventy cases suffered from chronic obstructive pulmonary disease（COPD） complicated with respiratory failure were divided randomly into standard therapy group（group A, n=35） and standard therapy＋NIPPV group（group B, n=35）. The patients in group A were treated with standard therapy only and those in group B were treated with both standard therapy and NIPPV through Bilevel positive airway pressure（BiPAP） mode. Results The levels of blood gas analysis had significantly improved in the group B including PH, PaCO2and PaO2, compared with pre-therapy（P〈0.05）. And while in the group A it was negative. The theory frequency of cannulas and the theory length of staying in the group B were better than those in the group A（P〈0.05）. Conclusion NIPPV through Bilevel positive airway pressure（BiPAP） mode can quickly improve the blood gas conditions of COPD complicated with respiratory failure, reduce the frequency of cannulas and length of stay in the hospital. It is a good method to cure respiratory failure.