无创正压通气对AECOPD不同程度二氧化碳潴留患者治疗效应的对比分析

The efficacy of non-invasive positive pressure ventilation for patients with different degrees of carbon dioxide retention secondary to acute exacerbation of chronic obstructive pulmonary disease

目的了解NPPV对AECOPD合并Ⅱ型呼吸衰竭的治疗效应和不同程度二氧化碳潴留水平对NPPV治疗效果的异同。方法对比分析NPPV对AECOPD并轻中度和重度二氧化碳潴留患者的治疗效应。AECOPD并轻中度二氧化碳潴留组(A组)74例,50.0 mmHg≤PaCO2<80.0 mmHg,平均(69.9±6.8)mmHg;AECOPD并重度二氧化碳潴留组(B组)64例,PaCO2≥80.0 mmHg,平均(92.0±10.7)mmHg。结果 NPPV在两组间NPPV的治疗有效率无显著差异(P>0.05)。在A组,同NPPV治疗前比较,pH值和PaO2在NPPV治疗2 h时、治疗第2 d、治疗第3 d和出院前pH值和PaO2显著升高(P<0.05);PaCO2在NPPV治疗第2 d、第3 d和出院前显著下降(P<0.05)。在B组,同NIPPV治疗前比较,pH值和PaO2在NPPV治疗2 h时、治疗第2 d、治疗第3 d和出院前均显著升高(P<0.05),PaCO2显著下降(P<0.05)。结论 NPPV对AECOPD不同程度二氧化碳潴留患者有很好的抢救治疗效果。

Objective To observe the efficacy of NPPV for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method Retrospective contrastive analysis the effect of NPPV for AECOPD patients with mild or moderate carbon dioxide retention and severe carbon dioxide retention.group A:74 cases,50.0 mmHg≤arterial partial pressure of oxygen(PaO2)<80.0 mmHg,with average(69.9±6.8) mmHg.group B:64cases,PaCO2≥80.0 mmHg,with average(92.0±10.7) mmHg.Results Compared to the pre-NPPV in group A,pH value and PaO2 increased significantly in every time point after NPPV(P<0.05),and arterial PaCO2 decreased significantly on the second day,the third day and the day prior to discharge(P<0.05).Compared to the pre-NPPV,pH value and PaO2 increased significantly and PaCO2 decreased significantly in every time point after NPPV(P<0.05).Conclusion NPPV are effective in AECOPD patients with severe carbon dioxide retention as well as patients with mild and moderate carbon dioxide retention.