慢性阻塞性肺疾病的机械治疗探析

Chronic obstructive pulmonary disease, Analysis of mechanical treatment

目的：探讨经面罩无创正压机械通气（NIPPV）在治疗慢性阻塞性肺疾病（COPD）稳定期慢性呼吸衰竭的临床应用价值。方法：以住院后随访COPD稳定期合并慢性呼吸衰竭的患者为研究对象，共37例，其中11例夜间长期（1年）应用无创呼吸机治疗，其余26例为常规治疗（未使用呼吸机）组。比较NIPPV前、后的血气分析、急性加重发作次数、肺功能和体重指数（BMI）等变化。结果：NIPPV治疗后PaC02、急性加重次数均有极显著下降（P〈０．01）；BMI、第1秒用力呼气容积（FEV1）占预计值百分比无明显变化。结论：COPD稳定期呼吸衰竭应用NIPPV治疗能有效改善生存状态。

Objective： To evaluate the mask noninvasive positive pressure ventilation （NIPPV） in the treatment of chronic obstructive pulmonary disease （COPD） with stable chronic respiratory failure in clinical application. Methods： The patient follow-up with stable COPD with chronic respiratory failure patients in this study, 37 patients, 11 cases at night the long-term （one year） non-invasive ventilation in the treatment, the remaining 26 cases of conventional therapy （not using a breathing machine） group. NIPPV compared before and after the blood gas analysis, the number of episodes of acute exacerbation, lung function and body mass index （BMI） and other changes. Results： NIPPV treatment PaCO2, the number of exacerbations were significantly decreased （P 〈0.01）; BMI, forced expiratory volume in 1 second ITEV1）% predicted no change. Conclusion： COPD and stable respiratory failure treatment can effectively improve the application of NIPPV existence.