双水平无创正压通气无创呼吸机治疗慢性阻塞性肺疾病合并呼吸衰竭的临床观察

Clinical observation of BiPAP ventilation in the treatment of chronic obstructive pulmonary disease with respiratory failure

目的探讨应用双水平无创正压通气（BiPAP）在慢性阻塞性肺疾病（COPD）合并呼吸衰竭与常规呼吸内科治疗的疗效对比。方法将90例入选患者随机分为治疗与对照两组，每组45例，在常规治疗（包括抗感染、祛痰、平喘、对症纠正电解质紊乱和酸碱平衡失调以及营养支持等治疗，并酌情给予糖皮质激素等）基础上，治疗组加用双水平无创正压通气治疗，3d为1个治疗阶段，观察患者3d后的症状体征及pH值、二氧化碳分压、氧分压、心率指标变化，并与对照组在血气分析各数值间做统计学分析。结果BiPAP治疗组患者临床症状、体征和血气指标在治疗后较治疗前有明显改善，与对照组相比差异有统计学意义（P均〈0．05）。结论BiPAP通气支持治疗COPD合并呼吸衰竭疗效显著。

Objective To compare the effect of bi -level positive airway pressure ventilation in chronic obstructive pulmonary disease （COPD） with respiratory failure and the therapeutic effect of conventional method. Methods Ninety patients selected were randomly divided into treatment and control groups, 45 cases in each group. The conventional treatment （including anti -infection, expectorant, asthma, symptomatic correction of electrolyte disorders and acid - base imbalance and nutritional support treatment, and when necessary given corticosteroids, etc. ） was the same, treatment group were given bi -level positive airway pressure treatment, 3 days for a treatment period, patients were observed for 3 days of the signs and symptoms and pH, PCO2, PO/, HR index changes, and with the control group made between the values of blood gas analysis of the statistical analysis. Results Of clinical symptoms in patients treated with BiPAP, signs and blood gas analysis after treatment than before treatment had significantly improved. Compared with the control group, there were significant differences （P 〈 0. 05 ）. Conclusions The effect of BiPAP ventilatory support for treating COPD with respiratory failure is good.